Nutritional Status of Hemodialysis Patients with Hepatitis C Infection

Nutritional Status of Hemodialysis Patients with Hepatitis C Infection

To the Editor,

I read with interest the article by Zamrutdal et al. on the effects of anti-HCV positivity on the markers of nutrition among patients with end stage renal failure undergoing regular hemodialysis.[1] It is not at all surprising that they did not find any differences in markers of inflammations and nutritional status in their study. This is because they had excluded patients with active disease (positive for HCV RNA) and advanced liver disease. Positivity for the serology in the absence of HCV RNA indicates that the patients had successfully cleared the infection either spontaneously or with treatment. As such, these patients are at very low risk of complications unless there is advanced liver disease. Hence, the comparison of these two groups is in fact a comparison of almost identical groups of patients. We recently assessed our own experience with patients undergoing hemodialysis.[2] The mean age of our patients who were positive for anti-HCV serology was comparable (43.1 ± 12.6 years old) with a mean duration of hemodialysis of five years. Although we were not able to compare specific markers of inflammations, as these are not done routinely, we did not find any difference in nutrition based on serum albumin when we compared those with positive and negative for HCV IgG. This is despite the fact that eighty percent of our patients with positive HCV IgG serology were positive for HCV viremia. Our results indicated that even with active disease, there were no differences in nutritional status based on serum albumin. However, the duration of follow-up of our study was short, and studies with longer follow-up are required considering the long natural history of hepatitis C infection.[3]