Evaluation of a Minipool Reverse Transcription-PCR Screening Method for the Detection of Hepatitis C Virus Infection in Hemodialysis Patients

The prevalence of anti-hepatitis C virus (HCV) antibody among patients on hemodialysis (HD) is consistently higher than in healthy populations, suggesting that dialysis patients may be at a higher risk of acquiring HCV infection (1). At present, the diagnosis of HCV infection relies mostly on immunoserological screening assays (ELISA) because they combine a direct evaluation of immune anti-HCV response, simplicity in both handling and performance, and a substantially lower cost (2). However, anti-HCV positivity may indicate past infection, current infection, or even nonspecific reactivity (3). HCV RNA determination through qualitative reverse transcription-PCR (RT-PCR) screening assays allows direct HCV detection before any serological alteration, including generation of antibodies or an increase in aminotransferase (4). In fact, several recent studies have demonstrated that de novo cases of HCV infection occur in HD units in the absence of other parenteral exposure (5). This finding underlines the spread of HCV among HD patients and the need for HCV RNA screening assays in the diagnosis of acute HCV infection in seronegative HD patients (6). Until recently, both qualitative and quantitative RT-PCR techniques had no practical application in diagnostic laboratories. Recently, several commercial diagnostic kits have been developed, offering high reproducibility and reliability (7). However, applying HCV genetic testing by means of an approved HCV RNA detection assay to …