EVIDENCE AGAINST TRANSMISSION OF HEPATITIS-C VIRUS THROUGH HEMODIALYSIS ULTRAFILTRATE AND PERITONEAL-FLUID

Hepatitis C virus (HCV) infection is highly prevalent in the chronic r enal failure population treated in dialysis units. Transmission of HCV via blood transfusions is becoming an increasing problem, but, nevert heless, the routes by which this transmission occurs are incompletely known. We have searched for the presence of HCV RNA by the polymerase chain reaction (PCR) in serum and dialysis ultrafiltrate in 12 hemodia lysis and 5 continuous ambulatory peritoneal dialysis (CAPD) patients, all of whom were HCV-antibody-positive. Serum PCR were positive for H CV RNA in all the cases, whereas PCR performed on samples of hemodialy sis ultrafiltrate or peritoneal effluent were always negative for HCV RNA. In addition, 13 patients tested positive for HCV antibodies and 1 9 out of 32 patients sharing the dialysis monitors with 17 PCR-positiv e individuals remained negative. From these findings, we conclude that the dialysis ultrafiltrate or peritoneal fluid seems to be an improba ble source of HCV dissemination in the dialysis setting. Moreover, a s ignificant group of patients remained HCV-antibody-negative although t hey shared the same dialysis machine with positive patients. Therefore , the importance of other sources of HCV transmission, namely blood-co ntaminated material, should be emphasized.