Antibodies anti HCV and anti HGV and the presence of these viruses in dialized patients


Tabor-Ciepiela, Barbara


hepatitis ; antibodies ; dialyses ; renal failure


The objectives of the study were as follows: - Assessment of frequency of the occurrence of antibodies against C and G viruses in hepatitis vs. presence of those viruses RNA in a group of patients treated with haemodialysis. - Observation of interdependencies between past and present HCV and HGV infections as well as indicators of damaging liver parenchyma. - Assessment of concurrent existence of infections caused by viruses of hepatitis, type G and C, and the influence of mixed HGV and HCV infections upon selected biochemical parameters and upon a clinical picture of a disease in patients undergoing haemodialysis. The studies were carried out in a group of 215 patients with terminal renal failure treated with repetitive haemodialyses in the Nephrology Clinic of the University in Kraków. In 40 patients out of 215, the presence of antibodies against C virus (anti-HCV) was reported. 117 patients (for economic reasons) were selected for further detailed analysis. That group included all patients (40) in whom the presence of anti-HCV antibodies was stated and 77 patients free from the HCV infection. In the analysed group of patients the following tests were performed: - Serology tests: aimed at identifying hepatitis C (anti-HCV) and hepatitis G (anti-HGV). - RT-PCR tests aimed at identifying in patients’ serum RNA of C virus (HCV-RNA) and G virus (HGV-RNA). - In addition, bi ; ochemical tests were performed in all patients in order to estimate the level of liver damage In order to find morphological changes in the liver and spleen as well as features of portal hypertension an ultrasound test was made. In the selected group of patients subjected to analysis, in 40 of them the presence of anti-HCV was reported, i.e. in 18.6 %, and in 42.5 % of them a positive HCV-RNA result was reported. It is worth emphasising that in patients dialysed peritoneally the percentage of anti-HCV antibodies is significantly lower and it ranges from 4.5 to 8%. In 8 (10.4%) patients in the anti-HCV negative group the presence of HCV-RNA was found. It makes us treat every dialysed patient as potentially infectious irrespective of the fact whether the presence of anti-HCV antibodies was reported in him/her or not. Diagnostics towards infection with hepatitis caused by G virus (anti-HGV antibodies) was performed in 93 patients (the number of determinations was limited by possibilities of the test used. The anti- HGV antibodies were reported in 42 patients (45.2%). In the group of patients in whom the presence of anti-HGV antibodies was declared, in 22 of them genetic virus material was determined, out of which in 14 patients (63.6%) the presence of HGV RNA was reported. Conclusions: 1. Reporting of a relatively high rate of dialysed patients with antibodies against viruses C ; and G causing hepatitis, as well as the presence of genetic material of those viruses is confirmed by the fact that HCV and HGV infections are frequent in haemodialysed patients. 2. Reporting the presence of HCV RNA in 10.4% of haemodialysed patients not showing the presence of anti- HCV antibodies makes us treat every dialysed patient as potentially infectious. 3. Duration of treatment by means of dialysis and medical procedures carried out before (kidney transplant) has an essential influence upon frequency of HCV infections occurrence. 4. Presence of HCV infections or co-existence of HCV and HGV infection may be responsible for a higher rate of changes in the liver ultrasound test. 5. Infections with virus G occurring in a high rate of dialysed patients seems not to have an essential influence upon behaviour of activities of liver enzymes analysed, whereas it may contribute to increasing the level of liver damage confirmed by means of ultrasound. Frequent co-existence of HCV and HGV infections may indicate a similar way of their transmission.

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2 - studia doktoranckie

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Wydział Lekarski


Sułowicz, Władysław



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Praca doktorska

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