{"title":"Anti-hepatitis C virus threshold value in predicting hepatitis C virus viremia in hemodialysis patients.","authors":"Vahibe Aydın Sarıkaya, Uğur Ayan, Sebahat Aksaray, Selami Erdinç, Burak Sarıkaya, Recep Balık, Seniha Şenbayrak, Serpil Erol, Asuman İnan, Nurgül Ceran","doi":"10.1590/1806-9282.20250184","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":94194,"journal":{"name":"Revista da Associacao Medica Brasileira (1992)","volume":"71 8","pages":"e20250184"},"PeriodicalIF":1.3000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452162/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista da Associacao Medica Brasileira (1992)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1590/1806-9282.20250184","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
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.
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