Hepatitis C, HCV genotypes and hepatic siderosis in patients with chronic renal failure on haemodialysis in Brazil

• Published in: Nephrology, dialysis, transplantation Vol. 22; no. 7; pp. 2027 - 2031
• Main Authors: de Paula Farah, Kátia, Carmo, Ricardo Andrade, de Figueiredo Antunes, Carlos Maurício, Serufo, José Carlos, Nobre Júnior, Vandack Alencar, Fonseca de Castro, Lúcia Porto, Leite, Virgínia Hora Rios, Silva, Rogério Augusto Pinto, Álvares, Maria Carolina Barbosa, Corrêa, Guilherme Oliveira, Busek, Solange Cristina Uber, Lambertucci, José Roberto
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.07.2007; Oxford Publishing Limited (England)
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Biopsy - adverse effects; Blood Donors; Brazil; chronic renal failure; Cohort Studies; Emergency and intensive care: renal failure. Dialysis management; Female; Genotype; genotyping; haemodialysis; Hepacivirus - genetics; hepatitis C; Hepatitis C - complications; Hepatitis C - virology; Hepatitis C virus; Human viral diseases; Humans; Infectious diseases; Intensive care medicine; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - pathology; Kidney Failure, Chronic - therapy; Liver - pathology; liver biopsy; Liver Cirrhosis - complications; Liver Diseases - complications; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Renal Dialysis; Renal failure; siderosis; Siderosis - complications; Viral diseases; Viral hepatitis; South America; Brazil; America; haemodialysis; chronic renal failure; liver biopsy; siderosis; hepatitis C; genotyping; Kidney disease; Human; Urinary system disease; Hemodialysis; Hepatic disease; Genotype; Infection; Extrarenal dialysis; Biopsy; Viral disease; Renal failure; Digestive diseases; Viral hepatitis C
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfm028

Background. The aim of this study was to investigate the HCV genotypes, hepatic siderosis, inflammatory activity and fibrosis of the liver in patients with chronic renal failure (CRF) on haemodialysis in Brazil. Methods. A cohort of 72 CRF patients was compared with a group of 65 candidates for blood donation (CBD). For the subjects selected, who tested positive for anti-HCV antibodies and were HCV-PCR positive, a protocol with epidemiological, clinical and laboratory information was completed. An ultrasound-guided liver biopsy was performed and histological analysis of liver fragments was carried out. The presence of HCV-RNA in plasma was established by nested-RT-PCR. The genotype was determined by Restriction Fragment Length Polymorphism (RFLP) analysis of the PCR product. Results. HCV genotype 1 was predominant in both groups, but genotype 2 was the second most common amongst CRF patients, and there was a significant difference when compared with the CBD group (P = 0.016). Regarding inflammation and fibrosis, no significant difference was observed in the histology of the liver between the study groups. Siderosis of the liver was more prevalent in the CRF group (P = 0.000). Severe complications of liver biopsies were reported in 10 CRF patients (13.2%). Conclusions. Genotype 2 was observed more frequently in the haemodialysis group. No statistically significant difference was detected between the CRF and CBD groups with regard to both inflammatory response and liver fibrosis. Hepatic siderosis has been attributed to excessive iron administration. As percutaneous liver biopsy resulted in severe complications, we suggest that other procedures of evaluating liver damage in CRF patients should be looked at thoughtfully.