ABNORMAL LIVER-FUNCTION TESTS .1.

A 28-year-old male with end-stage renal disease (ESRD) of unknown etio logy was on chronic hemodialysis for one year with reused high-flux di alyzers and universal infection-control precautions. Routine monthly c hemistry screening intermittently revealed serum aspartate aminotransf erase (AST, formerly glutamic-oxaloacetic transaminase, SGOT) and alan ine aminotransferase (ALT, formerly glutamic-pyruvic transaminase, SGP T) levels slightly above the normal range, but never approaching twice that limit. He had no history of blood transfusions, and was hepatiti s surface antibody positive at >10 IU/l after vaccination. He was sexu ally active, not monogamous, and claimed a ''safe sex'' lifestyle. Tes ted as part of a pretransplant surgical evaluation, antibody to hepati tis C was detected and then confirmed by immunoblotting (RIBA-2, Ortho Diagnostics). The dialysis staff questioned whether he should be isol ated, whether to continue reuse and what to do in case of an accidenta l needlestick.