A 3-YEAR FOLLOW-UP OF HCV-RNA VIREMIA IN HEMODIALYSIS-PATIENTS

Background. Hepatitis C virus (HCV) infection in a population of haemo dialysed patients was studied over a 3-year follow-up period in order to evaluate the changes in viral RNA, diversity of genotypes, and sero logical response to synthetic HCV peptides. Methods. Twenty-eight (32. 9%) patients with anti-HCV antibodies from a total of 85 patients assi gned to a haemodialysis unit were studied. The serological response to immunopeptides was evaluated by immunoblotting, viral RNA in serum wa s detected using the polymerase chain reaction (RT-PCR), and genotypin g was carried out by hybridization with probes fixed to nitrocellulose paper. Results. Of the 28 haemodialysis patients who had anti-HCV ant ibodies, three (10.7%) were always RNA negative, six (21.4%) were alwa ys RNA positive, and 19 (67.8%) were variable RNA. There was an incomp lete antibody response to non structural antigens in non-viraemic pati ents. Genotype was determined in 23 patients, and the other two could not be genotyped. The most common genotype was Ib (69.4%), followed by la (17.4%), and 2a, 3a, and 4a (each 4.4%). Conclusions. Haemodialysi s patients, when followed up for a long time, frequently show an inter mittent HCV viraemia state, suggesting that HCV cannot be evaluated ad equately by isolated RNA determinations.