HCV Viruses: A New Problem in Pediatric Dialysis Patients?

Amira Peco-Antić, MD, Assistant Professor of Pediatrics, University Children’s Hospital, Tiršova 10, 11000 Belgrade (Serbia) Dear Sir, Relatively little information is at present available on the prevalence of the hepatitis C virus infection (HCV) in dialysis pediatric patients [1]. In adult hemodialysis patients it ranges from 1% in the UK to 50% in Brazil [2, 3]. This study has been undertaken to assess the frequency of anti-HCV positivity in the Hemodialysis Unit (staff and patients) of the Belgrade University Children’s Hospital, and to evaluate its possible correlations with blood transfusions, hemodialysis age and biochemical indexes of chronic hepatic disease. Twenty-four patients underwent examination, 14 girls and 10 boys, who were on chronic hemodialysis from 1 to 164 months (mean age 13.33 ± 4.37 years and dialysis duration 29.75 ± 45.54 months). Four of them had hepatitis B virus infection (HBV) at least 1 year ago, and 8 had been given HBV vaccine. Of 24 patients, 20 had received one or more blood transfusions. Ten staff members (1 doctor, 1 medical technician and 8 nurses) were also evaluated. They have worked at the Hemodialysis Unit for an average 9.3 years (range 3-12 years). None of the staff members had history of blood transfusions, but 5 of them had HBV infection at least 4 years ago, and 4 had been give HBV vaccine. In periodic checks, biochemical assays (including alanine transaminase levels) were done monthly in all patients with a multichannel autoanalyzer. Complete screening for HBV, including HB surface antigen (HBs Ag), HB core antigen (HBc Ag), HBe antigen (HBe Ag) and antibodies to HBs, HBe and HBc antigens were done by enzyme immunoassays (Elisa) at the same time as the tests for HCV antibodies. These screenings were carried out in November 1990 (15 patients), July 1992 (14 patients) and September 1992 (13 patients), using for anti-HCV assay the Elisa test; the first generation test for the first check-up and the second generation tests for the others (table 1). Five patients were tested three times and 8 patients twice. Staff members