Unexpected distribution of hepatitis C virus genotypes in patients on hemodialysis and kidney transplant recipients

The distribution of hepatitis C virus (HCV) genotypes in patients on hemodialysis and in kidney transplant recipients was compared with that observed in a control group composed of HCV-infected individuals from the general population. A total of 340 patients were included in the study: 46 with end-stage renal disease on regular hemodialysis treatment, 22 kidney transplant recipients and 272 controls matched for sex and age at a 4:1 ratio (controls to patient). HCV genotype was determined by sequencing of the 5' untranslated region of the HCV genome. No difference was observed in the distribution of HCV genotypes in hemodialysis patients and renal transplant patients (P = 0.47). However, when each of these groups was compared with the control group, a significant difference was detected in the genotype distribution (P < 0.001). in hemodialysis and renal transplant patients the most prevalent subtype was 1a, followed by 1b, 3, and other less prevalent genotypes (2, 4, and 5), whereas in the control group the most prevalent subtype was 1b, followed by 3, 1a, and others. That observation may reflect differences in the epidemiology of HCV infection, viral characteristics and host factors in renal patients in comparison to the control group.Universidade Federal de São Paulo, Div Gastroenterol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Nephrol, São Paulo, BrazilFleury Med Diagnost Ctr, Mol Biol Sect, São Paulo, BrazilUniversidade Federal de São Paulo, Div Gastroenterol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Nephrol, São Paulo, BrazilWeb of Scienc

Iron overload in patients with chronic hepatitis C virus infection: Clinical and histological study

Background: Recently it has been found that iron is an important element in the natural history of hepatitis C. Serum markers of iron stores are frequently increased in chronic hepatitis C virus (HCV)infected carriers but the real impact of the hepatic iron overload is poorly understood. the purpose of the present paper was to determine the prevalence of iron overload and to study the relationship between hepatic iron concentration (HIC) and clinical, biochemical and histological characteristics in chronic HCV-infected carriers.Methods: Patients presenting with anti-HCV and HCV-RNA were included. Hepatic iron concentration was determined in liver tissue by atomic absorption spectrophotometry. the association between HIC and age, gender, risk factor of transmission, duration of infection, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, iron and serum ferritin, transferrin saturation, HCV-RNA level, grading of inflammatory activity, staging of fibrosis, hepatic steatosis, and stainable iron was analyzed. Statistical analysis included the Mann-Whitney test and a multiple linear regression model.Results: Ninety-six patients (58% male) with a mean age of 44 10 years were studied. Serum iron, ferritin and transferrin saturation were elevated in 28%, 27% and 12.5% of patients, respectively. Stainable iron was detected in few patients (15.6%). Higher grades of stainable iron (2 and 3) were observed in only 7%. the HIC (>30 mmol/g dry weight) was elevated in five patients (5%). Neither grading nor staging were related to HIC. Higher HIC were observed in male patients (P <0.001), in patients with elevated serum ferritin (P = 0.001) and in patients with stainable iron (grades 2 and 3. P = 0.001). Multiple linear regression analysis showed that only stainable iron was independently correlated with HIC (P = 0.003).Conclusions: Iron overload in chronically HCV-infected patients was uncommon and hepatic iron content seemed not to be related to the liver damage process. in the eventuality of iron overload, histochemical liver iron is a useful marker to estimate HIC. (C) 2004 Blackwell Publishing Asia Pty Ltd.Universidade Federal de São Paulo, Div Gastroenterol, Dept Gastroenterol, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pathol, BR-04023900 São Paulo, BrazilUniv São Paulo, Inst Nucl Energy & Res, São Paulo, BrazilUniv São Paulo, Inst Chem, São Paulo, BrazilUniversidade Federal de São Paulo, Div Gastroenterol, Dept Gastroenterol, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pathol, BR-04023900 São Paulo, BrazilWeb of Scienc