Diffusion of HCV through peritoneal membrane in HCV positive patients treated with continuous ambulatory peritoneal dialysis.

Purpose of the Study. We evaluated the pres- (2,3) and to the length of HD treatment (4-6 ). Nosocomial spread of HCV in HD units has been ence of HCV in the peritoneal euents of viraemic patients treated with continuous ambulatory peritoneal suggested by several authors (7-9) and a direct demon- stration that HCV can pass into dialysis fluids, albeit dialysis (CAPD) to evaluate the risk of transmitting the infection with this procedure. at low concentration, has been provided (10 ). In patients treated with continuous ambulatory peri- Procedure. Fifteen of 81 CAPD patients ( 18.5%) had anti-HCV antibodies and eight were viraemic. At toneal dialysis (CAPD) the prevalence of HCV markers is lower than in HD, ranging from 2 to 15% (11-16 ). the beginning of CAPD two of the viraemic patients had ascites with a clinical picture of chronic active The presence of HCV in peritoneal dialysis euent has been investigated by few authors with conflicting hepatitis and cirrhosis. Peritoneal dialysates were col- lected after an overnight exchange with 1.36% glucose results (15,17,18 ), and at present the prevalence of HCV-RNA positivity in peritoneal dialysate, the deter- and after a 4-h exchange with 3.86% glucose. Fluids from the overnight exchange were spun to obtain minants influencing its presence, and its relevance as a potential source of infection are not well defined. a cellular pellet and the supernatant 100-fold concentrated. In this study we evaluated the presence of HCV in the peritoneal euents of CAPD patients with HCV Results. No viral genome could be detected in uncon- centrated samples and in cellular pellets, while HCV- viraemia in order to evaluate the risk of transmitting the infection with this procedure. RNA at low titre was detected in concentrated dialys- ates from the two patients with active liver disease. Conclusions. Our findings confirm that HCV may Subjects and methods be present in the CAPD euent of some patients; however, the titre of virus in the euent was extremely Eighty-one CAPD patients ( 45 males, 36 females, age range low, at the limit of detection of the PCR assay. 23-85 years, median 63 years) were investigated for the Peritoneal fluids originating from patients with HCV presence of HCV antibodies and HCV-RNA in serum. These associated severe liver disease may be a potential source patients had been on CAPD for 1-145 months (median 27 ) of infection. performing 4-5 exchanges per day, 1.5 or 2 l each, using dierent double-bag disconnect systems (Baxter Y set,