Background: Hepatitis C virus (HCV) is a major cause of hepatitis in hemodialysis (HD) patients. Routes other than blood transfusion play a role in the spread of HCV in HD patients. Molecular studies of HCV implicate nosocomial transmission of the virus in HD units. We conducted a clinicovirological study in our HD unit to investigate if the hands of dialysis personnel could represent a mode of transmission of HCV among HD patients. Methods: One liter of sterile water was used for each handwashing of dialysis personnel. The washing was collected in a sterile container and tested for HCV-RNA by polymerase chain reaction (PCR) within 3 h of collection. Eighty handwashings from nurses dialyzing HCV-positive patients (groupe A) and 100 handwashing from nurses dialyzing HCV-negative patients (group B) were tested for HCV-RNA. As a control, 60 handwashings were collected from the dialysis personnel before entering the dialysis unit (group C) and tested for HCV-RNA. Results: HCV-RNA was positive in 19 (23.75%) of samples of group A, in 8 (8%) of samples of group B (p < 0.003) and in 2 (3.3%) of samples of group C (p < 0.35). These two positive samples of group C were from nurses who had dialyzed HCV-negative patients. Conclusion: These results indicate the presence of HCV-RNA on the hands of some dialysis personnel in our HD unit, in spite fo adherence to the standard precautions. The hands of dialysis personnel are therefore a potential mode for facilitating transmission of HCV between HD patients.

We assessed the dermatological manifestations associated with chronic hepatitis C virus (HCV) infection and their association with liver status. Of 155 patients with chronic HCV infection in Cairo, Egypt, 71 (45.8%) had dermatological manifestations: pruritus without evident skin lesions (21.3%), pigmented purpuric eruption (5.2%), aphthous ulcer and lichen planus (3.9% each), leukocytoclastic vasculitis (2.6%), psoriasis (1.9%), tinea versicolor (1.3%) and other conditions (5.8%). Shrunken liver, splenomegaly and ascites were significantly associated with the presence of skin lesions (relative risk 8.0, 2.7 and 1.8 respectively), and shrunken liver was significantly associated with pruritus (relative risk 2.1). Sex was not associated with any of the skin lesions.