Distribution of HCV Genotypes in Patients with End-Stage Renal Disease According to Type of Dialysis Treatment

  • Haldun Selcuk
  • Mehmet Kanbay
  • Murat Korkmaz
  • Gurden Gur
  • Ali Akcay
  • Hande Arslan
  • Nurhan Ozdemir
  • Ugur Yilmaz
  • Sedat Boyacioglu
Original Paper


The objective of this study was to investigate the effects of types of dialysis treatments on hepatitis C virus infection and the epidemiologic properties of hepatitis C virus (HCV) infection at three Baskent University hospitals, in Ankara, Adana, and Izmir, Turkey, in 655, 326, and 118 patients with end-stage renal disease, respectively. One hundred thirty patients with HCV viremia among 271 patients with end-stage renal disease seropositive for HCV were included in this cross-sectional study. HCV RNA-positive patients were classified according to the renal replacement therapies (hemodialysis or continuous ambulatory peritoneal dialysis), and viral load, transaminase levels, and distribution of genotypes were compared between these subgroups. In the continuous ambulatory peritoneal dialysis group, 26 of 165 patients (16%) were serum anti-HCV positive, and 11 of 26 patients (42%) were serum HCV RNA positive. Twenty-six percent of the patients undergoing hemodialysis were anti-HCV positive, and 49% were HCV RNA positive. The prevalence of genotype 1b was 68% and 73% for patients in the continuous ambulatory peritoneal dialysis and hemodialysis groups, respectively. No significant differences were found between the genotype 1b and the non-1b groups or between different dialysis types with regard to age and sex and serum aspartate transaminase, alanine aminotransferase, and HCV RNA levels. We conclude that HCV seropositivity may differ between different types of dialysis treatments, although viral load and genotypes may be similar in persons with end-stage renal disease and those without.


End-stage renal disease Continuous ambulatory peritoneal dialysis Hemodialysis Viral load 


  1. 1.
    Bukh J, Purcell RH, Miller RH (1992) Importance of primer selection for the detection of hepatitis C virus RNA with the polymerase chain reaction assay. Proc Natl Acad Sci USA 89:187–191PubMedCrossRefGoogle Scholar
  2. 2.
    Martin P, Friedman LS (1995) Chronic viral hepatitis and the management of chronic renal failure. Kidney Int 47:1231–1241PubMedCrossRefGoogle Scholar
  3. 3.
    Cendoroglo Neto M, Draibe SA, Silva AE, et al. (1995) Incidence of and risk factors for hepatitis B virus and hepatitis C virus infection among hemodialysis and CAPD patients: evidence for environmental transmission. Nephrol Dial Transplant 10:240–246PubMedGoogle Scholar
  4. 4.
    Hinrichsen H, Leimenstoll G, Stegen G, et al. (2002) Prevalence and risk factor of hepatitis C virus infection in hemodialysis patients: a muticentre study in 2796 patients. Gut 51:429–33PubMedCrossRefGoogle Scholar
  5. 5.
    Ng YY, Lee SD, Wu SC, et al. (1991) Antibodies to hepatitis C virus in uremic patients on continuous ambulatory peritoneal dialysis. J Med Virol 35:263–266PubMedCrossRefGoogle Scholar
  6. 6.
    Fabrizi F, Poordad FF, Martin P (2002) Hepatitis C infection and the patient with end-stage renal disease. Hepatology 36:3–10PubMedCrossRefGoogle Scholar
  7. 7.
    Simmonds P, Alberti A, Alter HJ, et al. (1994) A proposed system for the nomenclature of hepatitis C viral genotypes. Hepatology 19:1321–1324PubMedGoogle Scholar
  8. 8.
    Takada N, Takase S, Takada A, et al. (1993) Differences in the hepatitis C virus genotypes in different countries. J Hepatol 17:277–283PubMedCrossRefGoogle Scholar
  9. 9.
    Yoshioka K, Kakumu S, Wakita T, et al. (1992) Detection of hepatitis C virus by polymerase chain reaction and response to interferon-alpha therapy: relationship to genotypes of hepatitis C virus. Hepatology 16:293–299PubMedCrossRefGoogle Scholar
  10. 10.
    Chan TM, Lok AS, Cheng IK (1993) Prevalence of hepatitis C virus infection in hemodialysis patients: a longitudinal study comparing the results of RNA and antibody assays. Hepatology 17:5–8PubMedCrossRefGoogle Scholar
  11. 11.
    World Health Organization (1997) Hepatitis C: global prevalence. Weekly Epidemiol Rec 46:341–348Google Scholar
  12. 12.
    Simmonds P (1995) Variability of hepatitis C virus. Hepatology 21:570–583PubMedGoogle Scholar
  13. 13.
    Di Lallo D, Miceli M, Petrosillo N, et al. (1999) Risk factors of hepatitis C virus infection in patients on hemodialysis: a multivariate analysis based on a dialysis register in Central Italy. Eur J Epidemiol 15:11–14PubMedCrossRefGoogle Scholar
  14. 14.
    Fabrizi F, Martin P, Dixit V, et al. (1999) Detection of de novo hepatitis C virus infection by polymerase chain reaction in hemodialysis patients. Am J Nephrol 19:383–388PubMedCrossRefGoogle Scholar
  15. 15.
    de Medina M, Ashby M, Schluter V, et al. (1998) Prevalence of hepatitis C and G virus infection in chronic hemodialysis patients. Am J Kidney Dis 31:224–226PubMedCrossRefGoogle Scholar
  16. 16.
    Chen YD, Liu MY, Yu WL, et al. (2002) Hepatitis C virus infections and genotypes in China. Hepatobil Pancreat Dis Int 1:194–201Google Scholar
  17. 17.
    Ozsoy MF, Oncul O, Cavuslu S, et al. (2003) Seroprevalences of hepatitis B and C among health care workers in Turkey. J Viral Hepat 10:150–156PubMedCrossRefGoogle Scholar
  18. 18.
    Gurbuz AK, Doganalp K, Gulsen M (1993) Hepatit C virus infeksiyonunda aile ici gecis. Gastroenteroloji 4:405–408Google Scholar
  19. 19.
    Hafta A, Çolakoglu S, Akkiz H (1996) Cukurova bölgesinde cesitli risk gruplarinda anti-HCV seroprevalansi. Viral Hepatit Derg 1:46–49Google Scholar
  20. 20.
    Sayiner AA, Zeytinoglu A, Ozkahya M, et al. (1999) HCV infection in haemodialysis and CAPD patients. Nephrol Dial Transplant 14:256–257PubMedCrossRefGoogle Scholar
  21. 21.
    Soetjipto Handajani R, Lusida MI, et al. (1996) Differential prevalence of hepatitis C virus subtypes in healthy blood donors, patients on maintenance hemodialysis, and patients with hepatocellular carcinoma in Surabaya, Indonesia. J Clin Microbiol 34:2875–2880Google Scholar
  22. 22.
    Covic A, Iancu L, Apetrei C, et al. (1999) Hepatitis virus infection in haemodialysis patients from Moldavia. Nephrol Dial Transplant 14:40–45PubMedCrossRefGoogle Scholar
  23. 23.
    Picciotto A, Varagona G, Gurreri G, et al. (1993) Anti-hepatitis C virus antibodies and hepatitis C virus viraemia in haemodialysis patients. Nephrol Dial Transplant 8:1115–1117PubMedGoogle Scholar
  24. 24.
    Chan TM, Lok AS, Cheng IK (1991) Hepatitis C infection among dialysis patients: a comparison between patients on maintenance haemodialysis and continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant 6:944–947PubMedGoogle Scholar
  25. 25.
    Conwat M, Catteral AP, Brown EA, et al. (1992) Prevalence of antibodies to hepatitis C in dialysis patients and transplant recipients with possible routes of transmission. Nephrol Dial Transplant 7:1226–1229Google Scholar
  26. 26.
    Furusyo N, Hayashi J, Kakuda K, et al. (2001) Acute hepatitis C among Japanese hemodialysis patients: a prospective 9-year study. Am J Gastroenterol 96:1592–1600PubMedCrossRefGoogle Scholar
  27. 27.
    Fabrizi F, Martin P, Dixit V, et al. (1998) Acquisition of hepatitis C virus in hemodialysis patients: a prospective study by branched DNA signal amplification assay. Am J Kidney Dis 31:647–654PubMedCrossRefGoogle Scholar
  28. 28.
    Gilli P, Moretti M, Soffritti S, et al. (1990) Non-A, non-B hepatitis and anti-HCV antibodies in dialysis patients. Int J Artif Organs 13:737–741PubMedGoogle Scholar
  29. 29.
    Fabrizi F, Martin P, Quan S, et al. (2000) Serotyping strip immunoblot assay for assessing hepatitis C virus strains in dialysis patients. Am J Kidney Dis 35:832–838PubMedCrossRefGoogle Scholar
  30. 30.
    Puttinger H, Vychytil A (2002) Hepatitis B and C in peritoneal dialysis patients. Semin Nephrol 22:351–360PubMedGoogle Scholar
  31. 31.
    Yalçin K, Degertekin H, Akkiz H (1999) Güneydogu Anadolu’da HCV’na bagli kronik hepatitlerde HCV genotipleri. Turk J Gastroenterol 10(3):249–252Google Scholar
  32. 32.
    Gorriz JL, Miguel A, Garcia-Ramon R, et al. (1996) Prevalence and risk factors for hepatitis C virus infection in continuous ambulatory peritoneal dialysis patients. Nephrol Dial Transplant 11:1109–1112PubMedGoogle Scholar
  33. 33.
    Weinstein T, Tur-Kaspa R, Chagnac A, et al. (2001) Hepatitis C infection in dialysis patients in Israel. Isr Med Assoc J 3:174–177PubMedGoogle Scholar
  34. 34.
    Qian KP, Natov SN, Pereira BJ, et al. (2000) Hepatitis C virus mixed genotype infection in patients on haemodialysis. J Viral Hepat 7:153–160PubMedCrossRefGoogle Scholar
  35. 35.
    Fabrizi F, Martin P, Dixit V, et al. (2000) Biological dynamics of viral load in hemodialysis patients with hepatitis C virus. Am J Kidney Dis 35:122–129PubMedCrossRefGoogle Scholar
  36. 36.
    Hung KY, Lee KC, Yen CJ, et al. (1997) Revised cutoff values of serum aminotransferase in detecting viral hepatitis among CAPD patients: experience from Taiwan, an endemic area for hepatitis B. Nephrol Dial Transplant 12:180–183PubMedCrossRefGoogle Scholar
  37. 37.
    Herrine SK, Michael B, Ma WL, et al. (2002) Development of an HCV infection risk stratification algorithm for patients on chronic hemodialysis. Am J Gastroenterol 97:2619–2622PubMedCrossRefGoogle Scholar
  38. 38.
    Furusyo N, Hayashi J, Ariyama I, et al. (2000) Maintenance hemodialysis decreases serum hepatitis C virus (HCV) RNA levels in hemodialysis patients with chronic HCV infection. Am J Gastroenterol 95:490–496PubMedCrossRefGoogle Scholar
  39. 39.
    Gonzalez-Michaca L, Soto-Ramirez LE, Rodriguez R, et al. (2001) Viral hepatitis C in patients with terminal chronic renal insufficiency. III. Viral quantification. Rev Invest Clin 53:21–27PubMedGoogle Scholar
  40. 40.
    Roudot-Thoraval F, Bastie A, Pawlotsky JM, et al. (1997) Epidemiological factors affecting the severity of hepatitis C virus-related liver disease: a French survey of 6,664 patients. The Study Group for the Prevalence and the Epidemiology of Hepatitis C Virus. Hepatology 26:485–490PubMedCrossRefGoogle Scholar
  41. 41.
    Wiese M, Berr F, Lafrenz M, et al. (2000) Low frequency of cirrhosis in a hepatitis C (genotype 1b) single-source outbreak in germany: a 20-year multicenter study. Hepatology 32:91–96PubMedCrossRefGoogle Scholar
  42. 42.
    Abacioglu YH, Davidson F, Tuncer S, et al. (1995) The distribution of hepatitis C virus genotypes in Turkish patients. J Viral Hepat 2:297–301PubMedCrossRefGoogle Scholar
  43. 43.
    Bozdayi AM, Aslan N, Bozdayi G, et al. (2004) Molecular epidemiology of hepatitis B, C and D viruses in Turkish patients. Arch Virol 149:2115–2129PubMedCrossRefGoogle Scholar
  44. 44.
    Gonzalez-Michaca L, Mercado A, Gamba G (2000) Viral C hepatitis in patients with end-stage renal disease. II. Viral genotypes. Rev Invest Clin 52:491–496PubMedGoogle Scholar
  45. 45.
    Benani A, El-Turk J, Benjelloun S, et al. (1997) HCV genotypes in Morocco. J Med Virol 52:396–398PubMedCrossRefGoogle Scholar
  46. 46.
    Bouchardeau F, Chauveau P, Courouce AM, et al. (1995) Genotype distribution and transmission of hepatitis C virus (HCV) in French haemodialysed patients. Nephrol Dial Transplant 10:2250–2252PubMedGoogle Scholar
  47. 47.
    Fabrizi F, Lunghi G, Pagliari B, et al. (1997) Molecular epidemiology of hepatitis C virus infection in dialysis patients. Nephron 77:190–196PubMedCrossRefGoogle Scholar
  48. 48.
    Zamir D, Storch S, Zonder HB, et al. (1999) Hepatitis C virus seroconversion and genotype prevalence in patients and staff on chronic hemodialysis. J Clin Gastroenterol 28:23–28PubMedCrossRefGoogle Scholar
  49. 49.
    Andonov A, Chaudhary RK (1994) Genotyping of Canadian hepatitis C virus isolates by PCR. J Clin Microbiol 32:2031–2034PubMedGoogle Scholar
  50. 50.
    Abacioglu H (1997) Hepatit C virusunun virolojik ve moleküler özelikleri. Aktüel Tip Dergisi 2:143–150Google Scholar
  51. 51.
    Perez RM, Ferraz ML, Figueiredo MS, et al. (2003) Unexpected distribution of hepatitis C virus genotypes in patients on hemodialysis and kidney transplant recipients. J Med Virol 69:489–494PubMedCrossRefGoogle Scholar
  52. 52.
    Gonzalez-Peralta RP, Qian K, She JY, et al. (1996) Clinical implications of viral quasispecies heterogeneity in chronic hepatitis C. J Med Virol 49:242–247PubMedCrossRefGoogle Scholar
  53. 53.
    Alter MJ, Kruszon-Moran D, Nainan OV, et al. (1999) The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med 341:556–562PubMedCrossRefGoogle Scholar
  54. 54.
    Zeuzem S, Franke A, Lee JH, et al. (1996) Phylogenetic analysis of hepatitis C virus isolates and their correlation to viremia, liver function tests, and histology. Hepatology 24:1003–1009PubMedCrossRefGoogle Scholar
  55. 55.
    Beld M, Penning M, McMorrow M, et al. (1998) Different hepatitis C virus (HCV) RNA load profiles following seroconversion among injecting drug users without correlation with HCV genotype and serum alanine aminotransferase levels. J Clin Microbiol 36:872–877PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Haldun Selcuk
    • 1
  • Mehmet Kanbay
    • 2
  • Murat Korkmaz
    • 1
  • Gurden Gur
    • 1
  • Ali Akcay
    • 3
  • Hande Arslan
    • 4
  • Nurhan Ozdemir
    • 3
  • Ugur Yilmaz
    • 1
  • Sedat Boyacioglu
    • 1
  1. 1.Department of GastroenterologyBaskent University School of MedicineAnkaraTurkey
  2. 2.Department of Internal MedicineBaskent University School of MedicineAnkaraTurkey
  3. 3.Department of NephrologyBaskent University School of MedicineAnkaraTurkey
  4. 4.Department of Infectious DiseaseBaskent University School of MedicineAnkaraTurkey

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