Genotyping and prevalence of hepatitis c virus in dialysis patients in Gandhi general hospital - A tertiary care centre

Context: The present study was undertaken to determine the genotyping and prevalence of hepatitis c virus in dialysis patients as HCV genotyping has become a part of the pre-treatment evaluation. Studies correlating risk factors and genotypes of HCV infection prevalent in Haemodialysis patients are scanty. Therefore our study is conducted to study the prevalence, genotypes and risk factors in order to detect and try to curb HCV infection. Aims: To study the genotypes of hepatitis C infection and its prevalence in hemodialysis patients. Settings and Design and Period: Study was conducted in Gandhi hospital Secunderabad in 1 year period as Cross-sectional study. Materials and Methods: A total of 225 serum samples were collected from chronic renal failure patients who were undergoing Haemodialysis over a period of 1 year. The samples were screened for anti HCV antibodies by third generation ELISA test. 25 anti-HCV positive samples and 40 anti-HCV negative samples were randomly selected for HCV RNA detection using Trizol-Chloroform-Isopropyl alcohol method, HCV RNA was reverse transcribed with 200 U of maloney murine leukemia virus reverse transcriptase and random hexamers. Nested PCR was done. HCV RNA positive samples were genotyped with primers specific for core region of different HCV types by type specific PCR. Statistical Analysis Used: Statistical analysis of the data was done by chi-square (c2) test using EPIINFO 2000 software. The values of chi square test are interpreted as not significant >0.05, highly significant < 0.001. Results: Out of 225 hemodialysis patients 38 (16.8%) patients were anti HCV positive. Duration of dialysis was significantly longer in anti-HCV antibodies positive group with dialysis duration more than 2 years. Seropositivity is more in HD patients having dialysis at more than one centre. HCV RNA was detected in randomly selected 13/25 (52%) anti HCV positive patients and in 5/40 (12.5%) anti HCV negative patients. The genotype distribution was as 3a (61.1%), 2a (11.11%), 2b (5.5%), mixed genotypes (16.6%), untypable (5.5%). Conclusions: Duration of dialysis, number of centres used for dialysis and number of times dialysis was done are important associations for anti-HCV antibodies positivity. Genotype 3 was predominant (61.11%). Detection of genotypes helps in early initiation of specific therapy and helps in early prediction of prognosis in patients of chronic renal failure on hemodialysis.