Low levels of hepatitis C virus RNA in blood of infected patients under maintenance haemodialysis with high-biocompatibility, high-permeability filters
M. Angelico et al., Low levels of hepatitis C virus RNA in blood of infected patients under maintenance haemodialysis with high-biocompatibility, high-permeability filters, DIG LIVER D, 32(8), 2000, pp. 724-728
Background. Patients undergoing maintenance haemodialysis are often infecte
d with hepatitis C virus, yet the clinical course of liver disease is usual
ly mild. We investigated whether the hepatitis C virus viral load is influe
nced by the haemodialytic procedure and the type of dialyser.
Methods. Hepatitis C virus-RNA levels were measured using a quantitative po
lymerase chain reaction assay in predialysis blood from 51 hepatitis C viru
s-infected patients dialysed with different membranes. Paired pre- and post
-dialysis measurements were also obtained in 18 patients.
Results. Patients dialysed using cuprammonium-regenerated cellulose membran
es with low (cuprofan) or intermediate (cellulose acetate or diacetate) bio
compatibility had higher pre-dialysis hepatitis C virus-RNA levels (p<0.05)
compared to those dialysed with synthetic high-biocompatibility, high-perm
eability polymeric membranes (polyacrylonitrile, polysulfone, polymethylmet
hacrylate or polycarbonate). Hepatitis C virus-RNA levels were unrelated to
the duration of haemodialysis and the presence of abnormal transaminases.
A significant reduction (p=0.04) of serum hepatitis C virus-RNA levels was
observed after a single haemodialysis, particularly in patients with high p
re-dialysis viral load. Patients with low pre-dialysis hepatitis C virus-RN
A levels (<2.5x10(3) copies/ml) exhibited only minimal changes following th
e procedure. Four patients with medium-high basal viral load switched from
a low-biocompatibility/low-permeability to a high-biocompatibility/high per
meability filter had a marked reduction of viraemia after three weeks, in o
ne case followed by a new increase after return to the original filter.
Conclusions. Haemodialysis with high-biocompatibility/high-permeability fil
ters in hepatitis C virus-infected patients is associated with low blood le
vels of hepatitis C virus-RNA. This finding may be of clinical relevance, e
specially in patients listed for kidney transplantation.