Anti-hepatitis C virus threshold value in predicting hepatitis C virus viremia in hemodialysis patients.

OBJECTIVE

Hepatitis C virus prevalence is higher in hemodialysis patients than in the general population. It is recommended that patients who are detected to be anti-hepatitis C virus seropositive should be dialyzed in separate machines. In patients requiring urgent hemodialysis treatment, anti-hepatitis C virus seropositivity may cause confusion and delay in dialysis sessions.

METHODS

The aim of the study was to determine the most appropriate signal-to-cutoff value to predict hepatitis C virus viremia in hemodialysis patients and to evaluate the effect of genotype differences. A total of 12,280 anti-hepatitis C virus results from hemodialysis patients between 2021 and 2024 were examined.

RESULTS

The mean age of 563 patients included in the study was 57 years, and 330 (58.6%) were male. Of the 563 patients, 68 (12.07%) were true hepatitis C virus patients. The mean age of hepatitis C virus-ribonucleic acid(+) patients was higher than that of the hepatitis C virus-ribonucleic acid(-) group (p<0.018). Anti-hepatitis C virus signal-to-cutoff value was >1 in all true hepatitis C virus patients. Hepatitis C virus-ribonucleic acid was accepted as the gold standard to determine the best threshold value in receiver operating characteristic curve analysis, and the most appropriate signal-to-cutoff value was found to be 2.23. Sensitivity was 98.5%, specificity was 87.1%, positive predictive value was 51.2%, and negative predictive value was 99.8%. 49 (85.96%) of the patients were identified as genotype(-1; the most common subtype was genotype-1b (n=43).

CONCLUSION

Anti-hepatitis C virus negativity is a reliable result in hemodialysis patients. If anti-hepatitis C virus signal-to-cutoff ≥2.23 is detected, confirmation by direct hepatitis C virus-ribonucleic acid testing is recommended. In hemodialysis patients with anti-hepatitis C virus signal-to-cutoff values between 1 and 2.23, false positivity should be considered first, and confirmatory tests should be performed if anti-hepatitis C virus is reactive in a second sample.