Prediction of viraemia in Anti - HCV positive haemodialysed patients

ABSTRACT

The aim of this study was to determine the prevalence of hepatitis C virus [HCV] to establish a new reference alanine aminotransferase [ALT] value for hemodialyzed [HD] patients and to determine its role in predicting viremia in anti-HCV-positive HD patients. Four subject groups were studied Group I, hepatitis-free healthy controls with normal kidney function [no = 100]; group II, hepatitis-free HD patients [no = 37]; group III, non-viremic anti-HCV positive HD patients [no = 33] and group IV, viremic anti-HCV positive HD patients [no = 85]. In addition, five viremic anti-HCV-negative HD patients were included. ALT used for calculation was the mean of the four times measured during the study for each patient. Anti-HCV antibodies were assayed by enzyme linked immunosorbent assay [ELISA] [fourth generation] and PCR screening for HCV was performed twice during the year of the study. The results of the study showed that the mean ALT value of group II was significantly lower than in group I. No significant difference was found between groups II and III and the mean ALT value in group IV was highly significant than groups II and III. The upper limit for ALT in hepatitis-free HD patients was determined at 43 U/L. The sensitivity of the mean ALT value in the diagnosis of HCV viremia was 47%, the specificity was 97% and the positive predictive value was 97.6%