Seronegative anti‐hepatitis C virus antibody in hemodialysis patients

Abstract

Dear Editor, I read with interest the recently published article by El-Sherif et al. in your journal. The authors have reported a high prevalence of false-negative rate of antiHCV antibody among hemodialysis (HD) patients using molecular studies. I agree with the authors regarding the importance of nosocomial transmission of hepatitis C virus (HCV) infection among HD patients. I would like to emphasize that dedication of hemodialysis machines in HCV negative and positive patients by anti-HCV antibody screening cannot prevent the transmission efficiently. Furthermore, they found the HCV-RNA by reverse transcription polymerase chain reaction (RT-PCR) in 17.9% of anti-HCV-negative HD patients that grouped in falsenegative of anti-HCV antibody. I would like to add that one probability for this high rate may be related to contaminations during sampling, transferring, or processing for RT-PCR. The reason for that is the low rate of antiHCV seroconversion (21.4%) out of 14 false-negative anti-HCV patients. Phylogenetical analysis in any center among the patients can help us to better understand the similarities between the two HCV-RNA groups. Comparison between the anti-HCV positive and false antiHCV HD patients can help for better understanding the distribution of risk factors in the studied groups. Preor postdate transfusion of blood screening in Egypt is critical for any conclusion regarding the importance of this risk factor in the studied groups. In a published systematic review related to HCV infection in Eastern Mediterranean Regional Office of WHO, the prevalence rate of HCV infection in HD patients in Egypt was 48% and transfusion history was a risk factor. Finally, I would like to emphasize on the importance of HCV detection before renal transplantation; the infected HD patients have worse outcomes than HCV-negative HD patients after renal transplantation.