Hepatitis C virus (HCV / HCV) in dialysis fluids: concentration and molecular detection by real - time PCR
Infection of hepatitis C virus HCV - (HCV) is highly prevalent in patients with chronic renal failure attending dialysis units, and is a common cause of hepatitis in patients undergoing hemodialysis (HD). The prevalence of HCV infection in patients undergoing chronic hemodialysis are found in some studies to be 27.9%, when the same area the prevalence of HCV in blood donors is 0.8%.
When we investigated the prevalence of HCV antibodies, it is variable being high in some cases (5-54%).
It is therefore considered that there is an increased risk in these patients suffering from HCV infection. This increase has been linked to the possible dissemination hospital (nosocomial) virus and found related to blood transfusions and duration of hemodialysis (HD). In this regard it has been evaluated if the virus could pass the dialysate even at the low concentration. The risk of HCV infection appears to be lower in patients treated with continuous ambulatory peritoneal dialysis (CAPD: Continuous Ambulatory Peritoneal Dialysis). However, there are publications demonstrating that HCV may be present in the liquid effluent of CAPD, even when patients undergoing CAPD are very low viral load.
The results of HCV RNA finding peritoneal dialysis are contradictory. There are contradictory findings when the presence of HCV RNA (HCV RNA) in serum of patients and dialysis fluids is investigated. For example, there results published in 1994 (C. Candy, et al Evidence against transmission of hepatitis C virus through hemodialysis and peritoneal fluid ultrafiltrate Nephron, 1994, 66:.. 470-473), which as the title of the article considered unlikely. In this study, taking all patients HCV RNA and HCV antibodies, always negative results for the presence of HCV RNA in the ultrafiltrate hemodialysis. The lack of finding in this study may be motivated by the methodology for detecting the presence of HCV RNA, as it applied a methodology equal to that used for determining serum, not citing using any concentration procedure.
Some studies have shown that in some patients infecting genotype is the same as then located in the dialysate, which shows that the hepatitis C virus can pass through dialysis membranes.
The contradictory findings between the results published by other authors, we believe that they are related to the type of methodology used. First some publications do not indicate that the sample dialysate has undergone any concentrations, while others indicate that it has proceeded to 100 times the liquid concentrate. Moreover, not all molecular diagnostic methods for HCV are the same, some authors using a commercial method based on a conventional RT-PCR, while other methods used in real time PCR.
Tests in IVAMI:
Concentration of the dialysate and molecular detection by real - time PCR.
Dialysate: 50 mL.
Preservation and shipment of sample:
Refrigerated (preferred) for less than 2 days.
Frozen: over 2 days.
Cost of the test: