HEPATITIS-C ANTIBODIES IN DIALYSIS PATIENTS AND PATIENTS WITH LEUKEMIA

The prevalence of hepatitis C antibodies (anti-HCV) among multitransfu sed patients was studied and compared with predicted values obtained f rom a post-transfusion hepatitis study and from data on the prevalence of anti-HCV among blood donors. The prevalence of hepatitis B core an tibodies (anti-HBc) was also studied to determine the routes of transm ission of hepatitis C virus. The patients consisted of 65 dialysis pat ients (57 on haemodialysis and 8 on continuous ambulatory peritoneal d ialysis) and 71 leukaemia patients in long-term remission 49 with acu te myeloid leukaemia (AML) and 22 with acute lymphatic leukaemia (ALL) !. The presence of anti-HCV was investigated using a second generation enzyme-linked immunosorbent assay. Reactive samples were confirmed by a second generation recombinant immunoblot assay. Anti-HBc was studie d in the 65 dialysis patients and in 40 of the leukaemia patients. Thr ee (4.6%) of the 65 dialysis patients and 12 (24.5%) of the 49 AML pat ients were anti-HCV positive whereas all of the ALL patients were sero negative. The total number of blood units transfused to 134 patients ( data on two dialysis patients were not available) was 18,148, out of w hich 17,575 units had been transfused prior to the initiation of anti- HCV screening of blood donors. On the basis of the anti-HCV prevalence among blood donors and the incidence of post-transfusion hepatitis, t he predicted number of seropositive patients was 11 and 18, respective ly. Five of the 65 dialysis patients were anti-HBc positive, compared with only one of the 40 leukaemia patients. It is concluded that the a nti-HCV prevalence among dialysis and leukaemia patients is concordant with the risk of receiving contaminated blood products, whereas hepat itis B infection may have other routes of transmission in dialysis pat ients. (C) 1993 Wiley-Liss, Inc.