The significance of hepatitis C RNA detection in hemodialysis patients for isolation and therapy efficacy assessment

Abstract

Hepatitis C virus (HCV) infection is one of the main problems in hemodialysis (HD) units worldwide. Most of the laboratories in Libya depend on HCV antibody (HCV-Ab) detection by Immunochromatography tests (rapid test) or Enzyme Linked Immunosorbent Assay (ELISA). The positive HCV-Ab results mean that the patient is infected with HCV, but maybe he resolved the infection and the patient is not infectious anymore and no need to separate him for dialysis. This study aimed to find the difference between HCV Ab-positive patients and those who are HCV RNA-positive by PCR and to evaluate their therapy. 49 (26 males & 23 females) HCV-Ab positive patients by ELISA from Misurata HD units were included and were tested by PCR for HCV-RNA. Results showed that 36 (73.5%) 18 male and 18 female patients were HCV RNA positive, those 36 were treated with Zepatier (antiviral) and retested for HCV RNA. Only 4 (11.1% of total treated patients) male patients were HCV RNA positive after therapy, there was a significant difference between before and after treatment (p< 0.001). We concluded that the HCV RNA testing by PCR must be done for all patients to separate the positive, also the HCV RNA testing is significant for evaluating potentially infectious patients and therapy effectiveness.