HBV AND HCV GENOME IN PERIPHERAL-BLOOD MONONUCLEAR-CELLS IN PATIENTS UNDERGOING CHRONIC-HEMODIALYSIS

Patients undergoing chronic hemodialysis are at risk for infection wit h hepatitis B virus (HBV) and hepatitis C virus (HCV). As peripheral b lood mononuclear cells (PMNC) are known to be susceptible to infection of both HBV and HCV, assessment of viral genomes in those cells could uncover occult infections not detected by serologic methods or virus determination in serum. We investigated all 67 patients undergoing chr onic hemodialysis at a single dialysis unit by PCR for the presence of HBV or HCV genomes in serum as well as in PMNC. None of the 67 patien ts was HBsAg positive or showed HBV-DNA in serum, but in 5 patients HB V-DNA in PMNC was detected as the only marker of HBV-infection; those patients were also anti-HBc negative. In 9 patients HCV-RNA was positi ve in serum; in 5 of those patients it was also found in PMNC. Three o f these infected patients were negative for anti-HCV. One other patien t had no anti-HCV or HCV-RNA in serum, but was positive for HCV-RNA in PMNC. Thus, in 6 patients (8.9%) undergoing chronic hemodialysis we f ound evidence of infection with HBV or HCV by detecting Viral genomes in PMNC without the presence of viremia, antigenemia or specific viral antibodies in serum. The detection of viral genomes in PMNC could be useful in the positive identification of additional potentially infect ious patients.