RISK-FACTORS FOR HEPATITIS-C VIRUS-INFECT ION IN HEMODIALYZED PATIENTS IN TUNISIA

Hepatitis C virus antibodies (anti-HCV) was looked for using a third-g eneration ELISA (Ortho) in 130 chronic renal failure patients receivin g maintenance hemodialysis. Of the 52 (40%) reactive sera (IC95 : 40%/-8.4%), 46 (88%) were positive (at least two anti-HCV antibodies) by a RIBA and the other six (12%) were indeterminate (only one anti-HCV a ntibody). Anti-HCV seropositivity was significantly correlated with he modialysis duration (P=0.005) and with the number of blood transfusion s (P=0.003). Among the 34 patients with a negative history for blood t ransfusions, nine (26%) were anti-HCV positive, suggesting nosocomial transmission of the virus. No significant differences were found betwe en anti-HCV positive and anti-HCV negative subjects regarding hepatiti s B markers (AgHBs and anti-HBc). There was a highly significant corre lation between anti-HCV positivity and serum transaminase elevation (P <0.001). Ten of 21 anti-HCV-positive patients (47%) with high ALAT lev els tested negative for HBsAg and anti-HBc, consistent with a substant ial contribution of the HCV to the development of chronic liver diseas e in hemodialysis patients. Thirty-one of the 52 anti-HCV-positive pat ients had normal ALAT levels, suggesting that this parameter may be un reliable as a marker of hepatitis C in hemodialysis recipients.