ABSTRACT
Hemodialysis(HD) patients are a high-risk group for hepatitis C virus(HCV) infection. Detection of HCV-RNA is important for safety and environmental protection in HD units. PCR-based methods are unsuitable for analyzing large samples of HD patients, because conventional centrifugal extraction method fails to eliminate heparin, a potent inhibitor of PCR. We have reported the usefulness of a new HCV-RNA extraction method using specific capture probes and magnetic particles in comparison with conventional centrifugal extraction method in hemodialysis patients. In this study, we evaluated the rate of HCV infection and HCV-RNA positivity by using a magnetic extraction method. As a result, the rate of HCV infection in dialysis patients was significantly higher than that of healthy people, and positivity for HCV infection was found to be related to the duration of hemodialysis. It has been assumed that the rate of new HCV infection is decreased as the result of improvement in dialysis equipment, a decrease in the need for blood transfusion due to the availability of erythropoietin for renal anemia, and the introduction of anti-HCV screening for blood donors. Hospital infection was strongly suggested from the evidence that the correlation with the rate of HCV infection and duration of dialysis was not significantly changed. HCV-RNA positivity was observed in two among 435 HCV antibody-negative patients. Since HCV-RNA positivity has been observed in HCV antibody-negative patients in HD units, combination with HCV-RNA by the magnetic extraction method and anti-HCV antibodies should be useful for the treatment of HCV infection. In this study, the effectiveness of IFN therapy was expected in 56.7%(38/67) that were genotype2 and/or had a low viral load. A precise diagnosis using HCV-RNA assay by the magnetic extraction method and precise medication including IFN therapy is desired for improving the long-term prognosis of dialysis patients.
