EPIDEMIOLOGY OF HEPATITIS-C VIRUS-INFECTION IN PATIENTS WITH RENAL-DISEASE

This study was carried out to determine the prevalence of hepatitis C virus (HCV) antibodies and the epidemiologic factors associated with H CV infection in patients with chronic renal failure before the onset o f ESRD. Sex, age, type of renal disease, level of renal function, and history of blood transfusions and invasive procedures were analyzed in 226 patients with renal disease, compared with a population of 1,244 normal subjects and 124 patients with impaired immunity (patients havi ng autoimmune diseases and receiving chemotherapy treatment). Eighteen seropositive patients with renal disease (prevalence, 7.9%) were foun d, which was significantly higher than the prevalence in the normal po pulation (1.03% in blood donors, 0.98% in pregnant women; P < 0.001, c hi(2)) There was no significant association of sex, number of blood tr ansfusions, or history of invasive procedures with the presence of HCV antibodies. The prevalence of HCV antibodies was higher (16.6%) in pa tients with glomerulonephritis compared with patients diagnosed with i nterstitial nephritis, pyelonephritis, nephrosclerosis, diabetes melli tus, polycystic kidney, and miscellaneous renal diseases (P < 0.01, ch i(2)), There was a higher prevalence of HCV antibodies in patients wit h creatinine clearance lower than 30 mL/min (13%) compared with patien ts with creatinine clearance higher than 30 mL/min (2.7%) (P < 0.01, c hi(2)) These data suggest that HCV infection may be associated with th e pathogenesis of glomerulonephritis. Alternatively, glomerulonephriti s or severe renal insufficiency may increase the likelihood of HCV inf ection.