Influence of hepatitis C virus (HCV) viraemia upon serum ...
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Influence of hepatitis C virus (HCV) viraemia upon serum ...
with raised serum AST (P=0.0001) and ALT (P= tion, as previously shown by many investigators. 0.0001) levels in the dialysis patients of the whole. [1â16].
Nephrol Dial Transplant ( 1997) 12: 1394–1398
Nephrology Dialysis Transplantation
Original Article
Influence of hepatitis C virus ( HCV ) viraemia upon serum aminotransferase activity in chronic dialysis patients F. Fabrizi1, G. Lunghi2, S. Andrulli1, B. Pagliari3, S. Mangano4, P. Faranna5, A. Pagano2 and F. Locatelli1 1Nephrology and Dialysis Division, Hospital, Lecco; 2Institute of Hygiene and Preventive Medicine, University, Milano and Dialysis Units of 3Sondrio, 4Tradate, and 5Trescore Balneario Hospitals, Italy
Abstract Background. There are many reports concerning HCV in dialysis patients and most of them conclude that the clinical and biochemical features of hepatitis C are often silent in chronic dialysis patients. Elevated levels of serum alanine aminotransferase activity are a sensitive measure of hepatocellular injury, but so far the relationship between anti-HCV and ALT among chronic dialysis patients has been considered imperfect. To our knowledge, however, such an issue has not been adequately addressed. Methods. Demographic, biochemical, and virological data from 506 patients undergoing chronic dialysis treatment in four dialysis units in Lombardy, northern Italy were collected in order to assess the influence of virological and host factors on serum aminotransferase values. Results. Analysis of covariance showed that positivity for anti-HCV antibody was significantly associated with raised serum AST (P=0.0001) and ALT (P= 0.0001) levels in the dialysis patients of the whole study group. Logistic regression analysis performed in the subset of patients tested for HCV viraemia and genotype showed that detectable HCV RNA in serum is a strong predictor of raised AST (P=0.0001) and ALT (P=0.000001) values. Gender showed an independent weak influence on AST levels (P=0.055), serum levels of ferritin were significantly (P=0.042) associated with AST values, the coexistence of HBsAg infection and positivity for anti-HCV antibody was independently associated with raised ALT levels (P= 0.016). The other factors (including positivity for antiHCV ) showed no independent eect on serum aminotransferase levels when they were matched with HCV viraemia in our multivariate analysis. HCV RNA positive patients showed serum AST (P
