Surveillance of Hepatitis C Virus Infection in Hemodialysis Patient

In Japan, the rate of hepatitis C Virus (HCV) infection among hemodialysis patients is high (12.1%) ; yet, early detection of HCV infection among these patients is limited because their AST/ALT increase is small, an index or a standardized surveillance method is unavailable, the measurement of HCV antibody varies among facilities, and the conventional HCV-RNA test is costly. We applied the public HCV surveillance method to hemodialysis patients and examined its effectiveness. A total of 1,077 hemodialysis patient (690 males, 387 female ; mean age 59.8 ± 12.8 years old ; dialysis history 9.1 ± 6.0 years) were included. The public HCV surveillance method included a combination of HCV antibody, HCV core antigen, and HCV-RNA tests. Using this method, we detected 151 (14%) HCV antibody-positive patients, of whom the antibody was high in 89, medium in 50, and low in 12 patients. The conventional method would require all HCV antibody positive patients (n = 151) to undergo HCV-RNA test ; however, we only required 27 patients to undergo HCV-RNA test. The 82.1% reduction in the requirement for further testing shows that our method is cost effective and efficient. The surveillance method should be introduced to help reduce infection in hemodialysis patients