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Background:A high prevalence of hepatitis C virus (HCV) infection in patients with diabetic kidney disease (DKD) has been reported. However, the epidemiology and relationship between DKD and occult HCV infection (OCI)are unknown.Objetives: To determine the prevalence of OCI in a population without conventional markers of HCV infection diagnosed with DKD, and to study its possible clinical implications.Study design: This prospective study included 125 anti-HCV and serum HCV-RNA-negative patients with DKD for the presence of OCI. HCV-RNA was tested by real-time reverse transcription PCR in peripheral blood mononuclear cells and in plasma after ultracentrifugation. Results: OCI was positive in 10 patients (8%). The patients with OCI had significantly higher ferritin levels (p=.002) and monoclonal gammopathy (30% [3/10] vs. 0.87% [1/115] than the patients without OCI [p=.003]). We found similar plasma ALT and GGT levels and HbA1C in both groups. At the end of the follow-up, the progression rate of renal disease tended to be faster in the group with OCI relative to the negative one, but without a significant difference. We did not find an association between OCI and cardiovascular morbidity. Conclusions: There was an 8% prevalence of OCI in patients with chronic renal failure secondary to DKD, higher than in the general population. This occult infection does not appear to play a role in the control of diabetes, cardiovascular risk or steatosis. However, the progression rate of renal disease tended to be faster, and the incidence of associated monoclonal gammopathy was significant.

Occult Hepatitis C Virus Infection in Patients with Diabetic Nephropathy: Epidemiological and Clinical Implications