Serologic survey for control of hepatitis C in haemodialysis patients: third-generation assays and analysis of costs

There is little information about the serologic survey for control ofhepatitis C by using third-generation assays among chronic haemodialysis(HD) patients, and no analysis of costs has been made to this end. Aserologic survey for control of hepatitis C was performed in 190 HDpatients attending a single dialysis unit, using second- andthird-generation assays. Costs of both serologic surveys were calculated.Anti-HCV prevalence tested by third-generation assays increased from 25%(48/190) to 28% (53/190) compared to second-generation testing; 56% (9/16)of patients showing uncertain findings by second-generation tests gaveunequivocal results by third-generation assays; median duration of HDtreatment and raised amino transferase levels were positively associated(P=0.004 and P=0.012, respectively) with anti HCV detected bythird-generation assays. The serologic survey for control of hepatitis C inHD patients at our centre was slightly more expensive by third-generationassays compared to second-generation testing (US&buck;18 866 vsUS&buck; 17200 per year). In summary, the use of third-generation testslargely clarified the uncertain results of second-generation tests; newadditional positive patients were detected by third-generation assayscompared to second-generation testing. Third-generation assays showed theassociation of duration of HD treatment and raised aminotransferase levelswith anti-HCV antibody, as previously found by first- and second-generationassays. To date, third generation screening and confirmatory assays seemextremely useful in the serologic survey for control of hepatitis C in HDcentres without a considerable outlay.