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Hepatitis C virus (HCV) is responsible for a high percentage of cases of transfusional hepatitis and is often considered the etiological agent of numerous cases of non-A, non-B hepatitis in which parenteral transmission has not been documented. Patients undergoing hemodialysis are at risk for HCV infection. We used an immunoenzymatic method and confirmatory test (neutralization test) to determine serum anti-HCV antibody positivity in order to identify the factors associated with increased risk of HCV infection. We studied 63 hemodialyzed patients from eastern Sicily and compared the mean dialytic age and transfusion case history in positive and negative groups. 17.4 percent of the patients were anti-HCV positive. Mean dialytic age was significantly higher in the anti-HCV positive group. On the contrary no significant differences regarding transfusion case history or number of units of blood transfused were seen in the two groups. Our study confirms that hemodialyzed patients are at risk for HCV infection. This risk seems to increase with dialytic age. The lack of correlation between HCV and transfusion case history suggests that it may be a hospital-acquired infection.

Hepatitis delta virus (HDV) is a defective virus which requires the helper function of hepatitis B virus (HBV) for replication. HDV infection occurs only during or after HDV infection. Viral infection spreads parenterally in both cases. However, it has been reported that the risk of HDV infection is limited to hemodialysed patients, unlike the risk of HBV infection. In order to verify these findings the Authors studied 108 patients undergoing periodical hemodialytic treatment in order to study the delta antibodies present in their blood. Sixty-one of these subjects had received previous blood transfusions, 15 were HBsAg positive and 7 positive for other serological markers of the hepatitis B virus. None of the subjects examined was positive for anti HDV. Our results agreed with the literature reporting an incidence of positive HDV serological markers limited to hemodialyzed patients. The Authors observed that the behaviour of the HDV serological markers can vary from patient to patient and that it is impossible to furnish diagnosis of HDV infection after HBV and HDV clearance. Since these factors can lead to underestimation of the real incidence of HDV infection in hemodialyzed patients, the Authors underline the need to perform long term epidemiological studies and to investigate all the HDV serological markers.