Pesquisa e genotipagem do vírus da hepatite C em portadores de doenças renais crônicas submetidos à hemodiálise

Abstract

Patients with chronic kidney disease are at high risk of acquiring hepatitis C virus (HCV). The prevalence of hepatitis C in hemodialysis units is high. The study aimed to assess the presence of HCV and its different genotypes in patients with chronic kidney disease who underwent hemodialysis in Belém and metropolitan area in the state of Pará, Brazil, determining the prevalence of the virus genotypes and epidemiological characteristics of patients with chronic kidney disease. We conducted cross-sectional study, hemodialysis units in seven cities of Belém and metropolitan area in the period from October 2011 to April 2012. A questionnaire was applied to social data, epidemiological and on the presence of risk factors for viral hepatitis. Biological material was collected from the patients for HCV PCR and ELISA tests. Patients with the presence of viral RNA were evaluated for genotypes. The prevalence of antibodies to HCV between the groups was 8.4%, while 5.4% had viral RNA, with 0.1% among those who were negative. Genotype 1 was the most prevalent, with 86.1%, followed by type 2, with 11.6%. The type 3 was only 2.3%. Whereas epidemiological analysis showed male predominance, age 49, married or in a stable, low education level and family income of up to two minimum wages. The main cause of CKD was diabetes mellitus (34.4%), followed by glomerulonephritis (18.6%) and hypertension (17.1%). The duration of hemodialysis was significantly important risk factor for acquiring HCV (p = 0.012), with the majority of HCV patients who acquired the disease during hemodialysis were above 5 years of treatment (p = 0.0001). Another risk factor associated with HCV was prior organ transplant. We conclude that, in Belém and the metropolitan area, the prevalence of HCV in hemodialysis was high and the most frequent genotype is the same as the general population in northern Brazil.