DIFFUSION OF HCV THROUGH PERITONEAL MEMBRANE IN HCV POSITIVE PATIENTSTREATED WITH CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS

Purpose of the Study. We evaluated the presence of HCV in the peritone al effluents of viraemic patients treated with continuous ambulatory p eritoneal dialysis (CAPD) to evaluate the risk of transmitting the inf ection with this procedure. Procedure. Fifteen of 81 CAPD patients (18 .5%) had anti-HCV antibodies and eight were viraemic. At the beginning of CAPD two of the viraemic patients had ascites with a clinical pict ure of chronic active hepatitis and cirrhosis. Peritoneal dialysates w ere collected after an overnight exchange with 1.36% glucose and after a 4-h exchange with 3.86% glucose. Fluids from the overnight exchange were spun to obtain a cellular pellet and the supernatant 100-fold co ncentrated. Results. No viral genome could be detected in unconcentrat ed samples and in cellular pellets, while HCV-RNA at low titre was det ected in concentrated dialysates from the two patients with active liv er disease. Conclusions. Our findings confirm that HCV may be present in the CAPD effluent of some patients; however, the titre of virus in the effluent was extremely low, at the limit of detection of the PCR a ssay. Peritoneal fluids originating from patients with HCV associated severe liver disease may be a potential source of infection.