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NDT Advance Access published online on February 19, 2007
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfm028
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

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

Kátia de Paula Farah1, Ricardo Andrade Carmo2, Carlos Maurício de Figueiredo Antunes3, José Carlos Serufo1, Vandack Alencar Nobre Júnior1, Lúcia Porto Fonseca de Castro4, Virgínia Hora Rios Leite4, Rogério Augusto Pinto Silva5, Maria Carolina Barbosa Álvares1, Guilherme Oliveira Corrêa6, Solange Cristina Uber Busek6 and José Roberto Lambertucci1

1Infectious Diseases Branch, Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, 2Minas Gerais State Blood Center (Fundação Hemominas), 3Department of Parasitology, Institute of Biological Sciences, 4Department of Pathology, School of Medicine, 5Division of Radiology, University Hospital, Federal University of Minas Gerais and 6René Rachou Research Center, Fiocruz, MG, Brazil

Correspondence and offprint requests to: Dr José Roberto Lambertucci, Infectious and Parasitic Diseases Branch, Internal Medicine Department, Medical School of the Federal University of Minas Gerais, Av. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, Minas Gerais 30130-100, Brazil. E-mail: lamber{at}uai.com.br



  Abstract

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.

Keywords: chronic renal failure; genotyping; haemodialysis; hepatitis C; liver biopsy; siderosis

Received for publication: 17. 7.07
Accepted in revised form: 9. 1.07


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