Abstract
Purpose: To determine the Hepatitis C virus (HCV) load in peripheral blood specimens of patients with renal abnormality reporting to the nephrology unit and to correlate the viral load with different biomarkers in serum. Materials and Methods: Fifty peripheral blood specimens were obtained from patients reporting to the nephrology unit and these patients were categorized into three groups as Group I: Renal Transplant patients, Group II: Dialysis patients, Group III: Other patients. with elevated liver enzymes and renal pathology. Peripheral blood specimens collected from kidney transplant recipients (n = 11), dialysis (n=17) and others (n =22) were subjected to detection of antibodies to HCV, determination of viral load by Real Time PCR and biochemical profiling consisting of estimation of bilirubin, total protein, alanine aminotransferase, and alkaline phosphatase. Antibodies to HCV were detected by ELISCAN™ HCV and the viral load by using HCV RG RTPCR kit (QIAGEN, Hilden). Statistical analysis - T test and the logistic regression analysis assessing the correlation between viral load and serum bilirubin, Serum glutamate pyruvate transaminase (SGPT), Alkaline phosphatase, total protein were performed using SPSS software version 14.0 Results: Antibodies to HCV were detected by ELISA in 39 (78%) peripheral blood samples and genomic HCV was detected in 31 (62%) by RTPCR. In 8 (16%) patients, HCV antibodies only were detected and RTPCR did not reveal the presence of HCV in these specimens. Logistic regression analysis performed on biochemical parameters and viral load revealed correlation between alkaline phosphatase enzyme levels and viral load (Hosmer and Lemehow test P value< 0.05 statistically significant). Conclusion: Determination of viral load is a reliable diagnostic test in detection of HCV infection. Elevated levels of alkaline phosphatase enzyme could be associated with increased viral load. To the best of our knowledge, this finding is the first being reported in Indian literature.
Highlights
Hepatitis C virus (HCV) is a major cause of parenterally transmitted acute hepatitis [1]
Fifty peripheral blood specimens collected from kidney transplant recipients (n = 11), dialysis patients (n=17) and others with renal pathology (n =22) were subjected to detection of antibodies to HCV, Real Time PCR and serum biomarker study consisting of estimation of bilirubin, total protein, alanine aminotransferase, and alkaline phosphatase
HCV antibodies were detected in 8 (16%) patients by ELISA but HCV RNA was not detected by RTPCR
Summary
Hepatitis C virus (HCV) is a major cause of parenterally transmitted acute hepatitis [1]. HCV infection is a common cause of chronic liver disease that can lead to end-stage liver disease, including hepatocellular carcinoma [2,3,4]. Viral load, genotype, and elevated serum alanine aminotransferase (ALT) or serum glutamate pyruvate transferase (SGPT) levels may have clinical relevance [5,6,7]. When parenchymal liver cells are damaged, aminotransferases leak from the liver into the blood, resulting in elevated levels of aminotransferases and alkaline phosphatases. The viral load at 6 months is considered as a marker of remission [8, 9]
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