Hepatitis C Infection in a Pediatric Dialysis Population

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Abstract
A variable prevalence of hepatitis C (HCV) infection has been reported in adult patients on hemodialysis. We have studied HCV infection and associated risk factors in a pediatric dialysis unit. Sera from all 27 patients undergoing either hemodialysis or peritoneal dialysis in our unit were tested for antibody to HCV by enzyme-linked immunosorbent assay, and seropositives were confirmed by recombinant immunoblot assay. Records were reviewed for demographic, biochemical, and risk factor data. From the total of 27 patients (12 male, mean age 20.9 years, range 7.3 to 28.1 years), five were anti-HCV(+) (18.5%). All the anti-HCV(+) patients had been on hemodialysis (69 to 194 months, mean 105 months), while of the 22 anti-HCV(–) patients, only 14 had been on hemodialysis (5 to 209 months, mean 41.4 months), P < .005. All the anti-HCV(+) patients had received blood transfusions (10 to 124 units, mean 61.4 units) as had 12 of the anti-HCV(–) patients (1 to 54 units, mean 14 units), P < .02. Of the 5 anti-HCV(+) patients, only one had prior hepatitis B infection of the 22 anti-HCV(–) patients, three had hepatitis B surface antigen, and no others had evidence of hepatitis B infection. The most predictive risk factor for HCV infection was length of time on hemodialysis. Eleven of the 27 patients (40.7%) had abnormal alanine aminotransferase values, of whom four were anti-HCV(+), three were hepatitis B surface antigen(+), and one was seropositive for antibody to human immunodeficiency virus. Pediatric dialysis patients are at risk for HCV infection; the most predictive risk factor in this population is length of time on hemodialysis. Approximately one third of abnormal alanine aminotransferase values in pediatric dialysis patients may be caused by HCV.
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