Prevalence of Hepatitis C Virus RNA in Hemodialysis Patients: Comparison of Four Antibody Assays

José Chianale, MD, Department of Gastroenterology, Catholic University of Chile, Casilla 114-D, Santiago (Chile) Table 1. Prevalence of HCV RNA in hemodialysis patients Dear Sir, Hepatitis C virus (HCV) infection is the predominant cause of parenterally transmitted nonA, non-B hepatitis, and it is also a common condition among hemodialysis patients [1,2]. In a recent communication, Chan et al. [3], studying a group of hemodialysis patients, found that the results of a second-generation HCV immunoassay correlated well with the presence of HCV RNA determined by nested polymerase chain reaction (PCR). Since viral replication is a marker of infectivity and associated with the development of chronic liver disease, it may strongly influence the management of hemodialysis patients. In this study, we examined the prevalence of HCV infection in a group of patients on maintenance hemodialysis by two second-generation enzyme immunoassays (EIA II) and two immunoblot assays. The results were compared with the detection of HCV RNA in serum by nested polymerase chain reaction and Southern blot hybridization. Forty-five patients (28 men and 17 women) with chronic renal failure on maintenance hemodialysis at the Hemodialysis Unit of the Clinical Hospital of the Catholic University Medical School were enrolled. Anti-HCV antibody detection was performed using the EIA II of Ortho Diagnostics (Rari-tan, N.J., USA), which detects antibodies to C100-3, C-33, and C22 antigens, and the EIA II of United Biomedical (New York, N.Y., USA) which detects antibodies to NS3, NS4, and core antigens. The HCV-antibody-positi-ve samples were also analyzed by two immunoblot assays: RIBA II (Chiron, Emeryville, Calif., USA), which detects antibodies to the 5-1-1 ‚ C-100, C-33c, C22-3, and SOD antigens, and LiaTek-HCV (Organon Teknika, Boxtel) which detects NS4, NS5, and four core antigens. Samples were also tested for HBsAg, anti-HBcAg (EIAs of Abbott Laboratories), and serum alanine aminotransferase (ALT). Detection of HCV RNA was performed using the nested cDNA PCR on sera from anti-HCV-positive patients and on sera from 7 anti-HCV-negative hemodialysis patients, as previously described by Bukh et al. [4]. Synthetic oligonucleotides were synthesized using a DNA synthesizer (Applied Biosys-tem, model 391). The PCR was performed, using 100 μl serum, in duplicate on two different