REACTIVITY TO HEPATITIS-C VIRUS PROTEINS IN HEMODIALYSIS-PATIENTS

The reactivity to hepatitis C virus (HCV) proteins has been studied in a population of 20 patients undergoing hemodialysis due to chronic re nal insufficiency. Sera from all study subjects were HCV reactive by a screening test based upon recombinant antigens covering parts of the non-structural regions NS3 and NS4 and the structural Core region of t he putative HCV genome (HCV 2nd Cen, Abbott. Lab.). Antibodies to E2, Core, NS3 and NS4 regions were studied individually (anti-E2 by radioi nmunoprecipitation; anti-Core anti-NS and anti-NS4 by Matrix HCV, Abbo tt Lab.), and also by their origin (anti-Core vs anti-NS3/4 ASA, Abbot t Lab.). The reactivity always found (20/20) was anti-NS3/4 (ASA) and almost always (19/20) against NS3 (Matrix). When patients were distrib uted according to their alanine aminotransferasa level (ALT) (always n ormal, presently normal but initially high and always high), it was fo und that those patients with always normal ALT level had more reactivi ty to the Core protein (determined by ASA or Matrix) than the group of ALT always high (p<0,05). However, among the three groups, the reacti vities to non-structural proteins were not different, regardless of th e technique used. in the 14 patients presenting reactivity to E2/NS1, there was not association of anti-E2/NS1 and normal ALT; although, thi s reactivity was significantly associated to Core reactivity (as deter mined by ASA or Matrix) (p<0,01). Therefore, this study seemed to indi cate that, among hemodialysis patients, susceptibility to HCV chronici ty could be associated with a lower reactivity to structural proteins. This last observation could be related to an immune deficiency or to a reinfection with different HCV strains; and, also, it is possible to think of a lack of assay reactivity at low antibody concentrations.