Occult hepatitis C virus (HCV) infection is highly prevalent in hemodialysis patients, Spanish researchers concluded.

Using a polymerase chain reaction assay and in situ hybridization, Guillermina Barril, MD, of Hospital Universitario de la Princesa in Madrid, and collaborators tested for the presence of genomic and anti-genomic HCV-RNA in the peripheral blood mononuclear cells of 109 hemodialysis patients with abnormal levels of liver enzymes.

Forty-five percent of subjects had occult HCV infection, as indicated by the presence of genomic HCV-RNA, according to a report in the Journal of the American Society of Nephrology (2008; online ahead of print).

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In addition, 53% of these patients had ongoing HCV replication, as indicated by the presence of antigenomic HCV-RNA. Occult HCV infection was associated with a nearly fourfold increased risk of death, the authors noted.

Patients with occult HCV infection had been on hemodialysis significantly longer than patients without occult infection, and they had significantly higher mean alanine aminotransferase levels during the six months prior to study entry, the investigators reported.