HEPATITIS-C VIRUS-INFECTION IN RENAL DIALYSIS PATIENTS IN GLASGOW

A survey of all 483 adult dialysis patients in the three renal units i n Glasgow using second-generation ELISA was carried out to determine h epatitis C virus (HCV) seroprevalence in the summer of 1991 before the introduction of blood donor screening for antibody to HCV in the UK. Supplementary testing of ELISA positive sera was by second-generation immunoblot assay (RIBA-2, Chiron). Retrospective case note analysis an d testing of stored sera were performed to assess liver function and t he risk factors for acquisition of the virus. Nineteen of the 483 pati ents (3.9%) were seropositive. Sixteen patients had been transfused an d 12 had previous transplants. Seropositivity was associated with curr ent haemodialysis (P<0.01) rather than continuous ambulatory peritonea l dialysis (CAPD). Of those on haemodialysis, the time since first dia lysis was longer for seropositives (13.6 years) than for seronegatives (6.3 years) (P<0.01) but this did not apply to those on CAPD. Twelve of 19 (63.2%) seropositives had persistent elevations of alanine trans ferase compared to seven of 38 (18%) seronegative controls (P<0.01). T his large group of dialysis patients is at special risk of HCV infecti on but the seroprevalence is less than that reported from outside the UK despite the use of more sensitive techniques. The risk is associate d with haemodialysis and is probably largely due to blood transfusion. The introduction of screening of donated blood for HCV antibody shoul d reduce the incidence of new infection in dialysis patients.