Increase of HCV RNA concentration during hemodialysis treatment in patients with chronic hepatitis C

Abstract

Background: In hemodialysis (HD) patients, a decrease of serum HCV RNA concentration during HD has been reported.

Objectives: To evaluate the effect of two different extracorporeal blood treatments, HD and hemodiafiltration (HDF), on HCV RNA concentration under standardized conditions.

Study design: Eleven chronic HD patients with chronic hepatitis C (CHC) and thirty-three non-uremic patients with CHC as controls were studied. Blood samples were collected at baseline (t=0 min), 30 min (t=30), and 180 min (t=180) after start of HD or HDF. HCV RNA concentrations were determined by a real-time PCR assay. Values obtained 30 min and 180 min after start of HD or HDF were adjusted according to the ultrafiltration-induced hemoconcentration.

Results: Baseline HCV RNA concentrations were found to be similar in dialysis patients and controls (2.9E+06 vs. 5.8E+06 IU/ml). After adjustment for hemoconcentration, no significant differences of HCV RNA concentrations were observed when HD versus HDF treatments and blood samples collected pre versus those collected post membrane were compared. Adjusted HCV RNA concentrations increased by 13% (not significant) at 30 min and by 56% (p<0.001) at 180 min after start of HD or HDF. Inhibitory effects on PCR through heparin and uremic toxins could be excluded.

Conclusions: In contrast to recent publications, a significant increase of serum HCV RNA within 180 min after start of HD or HDF was observed. Changes in serum HCV RNA concentration are independent from HD and HDF procedures, dialysis membrane, heparin concentration, and uremic toxins.