Acute Hepatitis C Infection without Anti-HCV Antibody in a Chronic Hemodialysis Patient

Liver disease caused by hepatitis C virus (HCV) may cause significant morbidity and mortality among patients with end stage renal disease under maintenance hemodialysis (HD). The anti-HCV antibody detection is the current method used to detect HCV infection. However, there are many seronegative HCV infections. Reverse transcriptase polymerase chain reaction for HCV RNA provides a better diagnostic tool to detect the infection. We present a chronic hemodialysis patient with HCV infection. HCV RNA was present in his blood, but not the anti-HCV antibody. Subtle clinical symptoms and slight elevation in hepatic enzyme was the only clue of the acute infection. The results of this case report indicated that small clinical signs and symptoms are helpful in the diagnosis of low viral load seronegative HCV infections in hemodialysis patients. (Chang Gung Med J 2006;29(4 Suppl):35-8)