Abstract
Aim: Hepatitis C virus (HCV) infection is common among the Egyptians. This prevalence is higher among hemodialysis (HD) patients in whom anemia is a common finding. Recently, some case reports and few studies indicated that red cell status increased after hepatitis C viral infection among HD patients. The aim of our study is to investigate whether HCV-positive HD patients have higher hemoglobin (Hb) and hematocrit (HCT) values compared to HCV-negative patients. Methods: Ninety-nine chronic (HD) patients were the subject of this study. Their HCV status was determined by anti-HCV antibodies and confirmed with RNA polymerase chain reaction (PCR). Those with a history of blood transfusion or massive blood loss during the last 6 months were excluded from the study. Results: 70.7% of our patients tested positive for anti-HCV antibody (56.9 % were male). The mean age for HCV positive group was (40.41±14.17 years) while it was (47.35±19.18 years) for HCV negative group (P=0.08). HCV positive group has a longer hemodialysis duration (66.54 ± 43.92 months) compared to HCV negative patients (30.96±23.17 months, P=0.006). Mean Hb was similar in HCV-positive compared to HCV negative group (10.32±2.03 versus 10.22±1.52 gm/dl respectively) (P=0.63). Mean HCT values were also similar in both groups being 30.94± 6.089% in HCV positive versus 30.77± 4.53% in HCV negative group, respectively (P= 0.094). Fifty-five patients (39 HCV positive and 16 were HCV negative) received erythropoietin (EPO) therapy whilst only twenty patients received IV iron. Mean Erythropoietin dose was 5000±2236.06 Units/week in HCV- positive patients versus 6250±2720.29 Units /week in HCV - negative group (P=0.09). Liver function tests were normal except for alanine aminotransferase (ALT) that was significantly higher among HCV-positive compared to HCV-negative patients (31.75±36.4 vs 15.1±7.21 U/L, P=0.05). Conclusion: HCV-positive and HCV-negative Egyptian chronic hemodialysis patients have comparable hemoglobin as well as hematocrit levels and the erythropoietin dose was not influential as its lower value in HCV-positive patients did not reach a statistically significant level.
Highlights
170 million people worldwide are chronically infected with the hepatitis C virus (HCV) [1]
Clinical and Laboratory characteristics of HCV positive patients Among 120 chronic HD patients who had been followed in our in-center HD units, 21 were excluded (6 patients had Adult Polycystic Renal disease, 8 were HBV positive and 7 had a history of blood transfusion in the previous 6 months) and the remaining 99 patients (68 male and 31 female) who had a mean age of 42. 81±16.63 years were the subject of this study
Seventy patients tested positive for HCV by third generation enzyme–linked immunosorbent assay (ELISA) test that was confirmed by polymerase chain reaction (PCR) giving a prevalence of 70.7% for HCV infection among our HD patients
Summary
170 million people worldwide are chronically infected with the hepatitis C virus (HCV) [1]. Anemia is the most common hematological abnormality in chronic renal failure. 12 30.96±23.17 73.78±13.7 132.02±23.74 4.99±0.83 144.33±147.85 3.26±0.50 15.1±7.21 19.67±7.84 0.54±0.21 191.6±41.59 108.57±28.45 9.12±0.94 5.47±2.24 ns ns 0.006 0.002 ns ns ns ns 0.05 ns ns ns ns ns ns past, blood transfusion was the essential method in the treatment of renal anemia, whereas the transfusion requirement has recently lessened by the use of erythropoietin (EPO). Iron deficiency is frequent in patients with renal failure and iron need is increased by erythropoietin therapy; iron replacement is very important in the treatment of renal anemia. Erythropoietin requirements and levels in HCV-positive and -negative patients were reported to be different in patients with end-stage renal disease (ESRD) [8,9]. In view of the recently published data reporting higher hemoglobin and hematocrit levels in HCV-positive compared to HCV-
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