Hepatitis C patients on maintenance hemodialysis show complex immune disturbances in the peripheral blood.

Hepatitis C virus (HCV) infection is prevalent in patients with maintenance hemodialysis (HD). Although HCV affects the survival rate, antiviral treatment for HD patients is limited. Since impaired innate immunity has been proposed both in hepatitis C and in HD, we compared the immunologic features in periphery between these patients and controls. Thirty subjects were divided into four groups on the basis of HD and HCV infection. In peripheral blood mononuclear cells, NK subsets and their activation status were analyzed by flow cytometry. Cytokine productions were measured both in the culture supernatant and at the single cell level. In HCV-infected HD patients, CD56(dim) NK subset was decreased (13.1±3.7%, p=0.015) but had upregulated CD69 expression (10.4±4.2%, p=0.032) compared to the other groups. LPS effectively induced neither interferon (IFN)-γ nor tumor necrosis factor (TNF)-α in NK cells of both HCV-infected and -uninfected HD patients, while TNF-α-producing monocytes were increased in HCV-infected HD patients as compared to the uninfected. These findings indicate that chronic HCV infection affects innate immunity independently of HD.