THE ROLE OF TISSUE ANTIGENS IN HEPATITIS C INFECTION THE OCCURENCE OF IN DIALYSIS PATIENTS

The possible role of HLA antigens in the occurence and the chronicity of Hepatitis C Infection (HCV) in dialysis patients is investigated in this study.

The study was performed on a total of 109 patients, 66 of whom were male and 43 were female, and the mean age was 37 (15-70). Eighty-two (75%) were on hemodialysis(HD), twenty seven were on continouos ambulatory peritoneal dialysis (CAPD); and the mean duration of dialysis was 49 (3-160) months. Prevelance of anti-HCV was 48.6% in the whole group of patients. The prevelance of anti-HCV in the HD group was significantly higher than that of CAPD patients (59.7% and 14.8%. respectively; p.0.0000). The duration of dialysis in patients with anti-HCV (61.9±4.9 months) was significantly longer than that of anti-HCV negative patients (36.93.2 monthsj. (p.0.0000). The prevelance of ALT elevations in anti-HCV positive patients (64.2%) was significantly higher than that of anti-HCV negative patients (12.5%), (p:0.0000). When the relations between anti-HCV and the frequency ofHLA-A, B, C and DR antigens were assessed, an inverse relationship between the presence of anti-HCV antibody and HLA-A28 (p:0.057), DR52 (p:0.047) was found. When the relation between the ALT levels and HLA antigens was investigated the frequency of HLA-A 3 (p:0.03), A30 (p:0.079) and B22 (p:0.079) was significantly high in anti-HCV positive patients.

Our results suggest that, the type and duration of dialysis were important risk factors in the occurence of HCV infection. Besides this, the presence or absence of some tissue antigens may play role in the development of chronic liver disease by modulating the immune response of the host.