ABSTRACT
This study was conducted on 100 haemodialysis [HD] patients [69 females and 31 males], from 8 to 67 years [mean 30.9 + 11.9 SD] and 50 apparently healthy controls with matched age and sex. All subjects were investigated for serum bilirubin, albumin, alanine transaminase [ALT] and aspartate transaminase [AST]. Serum hepatitis C virus [HCV] antibodies were detected by 2nd generation ELISA [ElAll] and 2nd generation RIB A test [RIBAII]. Serum HCV-RNA was assessed by reverse transcriptase -polymerase chain reaction [RT-PCR]. Haemodialysis patients were also subjected to Hepatitis B surface antigen [HbsAg] detection and histopathological examination of rectal snip to diagnose Schistosoma infection. Genotyping of [19] positive HCV RNA patients was performed using the INNO-LiPA [line probe assay] HCVII Kit [Innogenetics, N. V., Belgium]. Seventy seven [77%] of HD patients were found to be positive for HCV by EIAII, 68 of them were also positive by RIBA II and 8 were intermediate. HCV RNA was detected in 38% of patients by RT- PCR. A significant correlation between HCV infection in these patients versus length of time and frequency of dialysis as well as number of previous blood transfusion [P=0.009, P= 0.03, p=0.001 respectively] was detected suggesting nosocomial spread of HCV infection within the HD units. No significant correlation between HBsAg positivity and HCV infection was detected by EIAII, RIBAII, or PCR. Schistosoma infection was not significantly associated with anti-HCV status by using RIBAII or RT-PCR [p=0.9]. Genotyping of 19 HCV RNA positive patients on chronic HD revealed that genotype 4 was the predominant one [68.4%, 52.6% type 4 perse and 15.8% type 4 subtype h], type 1 was detected in 10.6% [5.3% for each of type 1a and 1b], while the remaining 21% were untypable strains. Further epidemiological and molecular studies to identify the routes by which HCV could be transmitted in HD units are needed