Viral hepatitis C in patients with end-stage renal disease. III. Viral quantification

Background. We have previously shown that the prevalence of hepatitis assoc iated with the hepatitis C virus (HCV) in patients with end stage renal dis ease in our institution is 10.2%. However, quantification of viral RNA in p lasma and its relation with clinical variables has never been studied in ou r patients. Thus, the aim of the present work was to quantify the HCV ui, a l load in patients with ESRD in dialysis, and to correlate these values wit h the dialysis modality and the viral genotype. Methods. We performed a tra nsverse, prolective and comparative study in patients with HCV infection in hemodialysis, continuous ambulatory peritoneal dialysis and patients in pe ritoneal dialysis, but with history of hemodialysis. Viral load was quantif ied with RT-PCR by using a commercial kit known as Amplicor HCV 2.0. Clinic al variables studied were: age, gender; end stage renal disease etiology, m odality and time in dialysis, transfusions, serum albumin, aminotransferase s, blood urea nitrogen, and serum creatinine. Results. Twenty four patients in dialysis with HCV infection entered into the study. Of these patients, 25% were on peritoneal dialysis, 29% on peritoneal dialysis with history of hemodialysis, and 46% were in hemodialysis. The average viral load (copies x 10(6)/mL) was 1.41 +/- 3.01. Viral load was lower in patients or, perito neal dialysis than in patients treated, or with history of hemodialysis 10. 20 +/- 0.12 vs 2.04 +/- 0.88; p < 0.05). WE observed no differences in vira l load among patients with different viral genotypes. Discussion. The avera ge viral load of our patients in dialysis is lower than the levels usually observed in hepatitis C infected patients without end stage renal disease. The lower viral load in patients treated with peritoneal dialysis, and no h istory of hemodialysis, probably denotes lower risk of chronic liver diseas e in these subpopulation.