Rajasekaran, C (2017) Evaluation of Serological Markers with Nucleic Acid Based Assay in Diagnosis of Hepatitis C Virus Infection among Chronic Kidney Disease patients in a Tertiary Care Hospital. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: HCV is the major cause of non-A non-B hepatitis. HCV is endemic in most parts of the world. The global prevalence of Hepatitis C virus (HCV) infection is around 3%. Three to four million people are newly infected every year worldwide. HCV is one of the major cause of transfusion associated acute hepatitis. Infected persons serve as major source for transmission. They are at more risk for developing chronic liver disease, which may progress to cirrhosis and primary hepatocellular carcinoma. HCV is a major cause of liver disease in patients with Chronic kidney disease (CKD) on maintenance hemodialysis. The prevalence of HCV infection among CKD patients is much higher when compared to the general population. Risk factor for spread includes history of transfusion, amount of blood products transfused, and duration of hemodialysis therapy. MATERIALS AND METHODS: A total of 82 patients diagnosed with CKD at our Nephrology Unit were included in the study. After obtaining informed consent from the patients who were enrolled for this study, epidemiological data were collected. All the patients were tested for HCV by anti-HCV antibody detection by third generation ELISA, Combined -HCV antibody and Capsid antigen detection by ELISA, and Real time PCR. RESULTS: Mean age of the CKD patients in our study group was 35.82. More than two third of the CKD patients in our study were male. In our study Hypertension and Diabetes mellitus were the commonly associated conditions in CKD patients In our study 7 patients were tested positive for HCV by antibody ELISA(8.53%), 9 patients were tested positive for HCV by antigen- antibody combined ELISA (10.97%). 11 were tested positive for HCV by PCR (13.41%). Prevalence of HCV in our study group was 13.41%. 11 patients who were tested positive for HCV in our study underwent hemodialysis for more than 24 months. Out of 27 patients who had change of dialysis centre 9 were tested positive for HCV. Prevalence of HCV in our study group was 13.41%. HCV antibody ELISA had sensitivity of 63.63% and specificity of 100% when compared with gold standard PCR. HCV combined antigen-antibody ELISA had sensitivity of 81.81% and specificity of 100% when compared with gold standard PCR.Positive predictive value of HCV antibody ELISA was 100% where as negative predictive value was 94.66%. Positive predictive value of HCV combined antigen-antibody ELISA was 100% where as negative predictive value was 97.26%. CONCLUSION: Adopting universal precautions in hospital and health care settings prevents the nosocomial spread of HCV. In CKD patients with poor immune response antibody ELISA alone is not sufficient for diagnosis of HCV infection. Combined antigenantibody ELISA can be substituted as a diagnostic test where nucleic acid testing facilities are unavailable.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.201414008 |
| Uncontrolled Keywords: | Chronic kidney disease, hemodialysis, HCV, ELISA, PCR. |
| Subjects: | MEDICAL > Microbiology |
| Depositing User: | Subramani R |
| Date Deposited: | 18 Jul 2020 17:01 |
| Last Modified: | 19 Jul 2020 03:40 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12538 |
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