Hepatitis C infection in two urban hemodialysis units

Abstract

We determined the prevalence of antibodies to the hepatitis C virus (anti-HCV) in 90 patients and 37 staff members of two hemodialysis units utilizing a recently developed anti-HCV recombinant based assay. Eleven patients (12%) were anti-HCV(+). Of these, eight (73%) had antibodies to the hepatitis B core antigen (anti-HBc) indicating prior hepatitis B infection; one patient was hepatitis B surface antigen (HBsAg)(+). All staff members were anti-HCV(-), although seven (19%) of them were anti-HBc(+). Alanine aminotransferase elevations were present at the time of the study in four anti-HCV(-) patients and in only one anti-HCV(+) patient. All anti-HCV(+) (mean 59 +/- 74; range 3 to 269 units) and 85% of anti-HCV(-) patients (mean 16 +/- 27; range 0 to 204 units) had received multiple blood transfusions (P = 0.348). Among 50 patients tested for human immunodeficiency virus (HIV), 43% of anti-HCV(+) as compared to only 7% anti-HCV(-) were positive (P = 0.003). There was a history of intravenous drug abuse (IVDA) in eight (72%) of the anti-HCV(+) patients and in only seven (9%) of the anti-HCV(-) group (P = 0.00001). The results of this serologic survey suggests that anti-HCV positivity is prevalent, although much less than anti-HBc, among our dialysis patients, whereas it was not detected among staff members. The prevalence rate of anti-HCV was statistically significantly higher among anti-HIV(+) and IVDA patients but not in multi-transfused patients.

Seroprevalence of HCV Infection Among Patients in a Tertiary Care Hospital in Bangalore

“…Therefore, strict adherence to universal precautions and careful attention to hygiene are recommended to reduce the transmission of HCV in dialysis units. [21], [11] Contradictory to our finding, other studies show prevalence of 1-28%. [1], [21], [11], [26], [17] This low prevalence can be attributed to the fact that the risk of acquiring HCV infection in haemodialysis units has decreased partially after the isolation of HCV positive patients in separated haemodialysis units.…”

“…[4] The mean duration of haemodialysis was two years compared to other studies which showed higher mean duration of six years by Mohammed Ali et al and 7.2 years by Jeffers et al [22], [21] HCV was found to be more prevalent among patients who had undergone haemodialysis for a longer duration owing to greater exposure over the years.…”

“…The available data suggests that HCV is a major cause of NANB hepatitis throughout the world. [21] The spread of HCV in haemodialysis units is declining, but the prevalence of HCV continues to remain high in this group of patients. [4] The overall HCV seroprevalence in our study was observed to be 8.4%.…”

Anticorpo contra o vírus C da hepatite em pacientes sob programa de hemodiálise em Salvador, BA, Brasil

“…Entre pacientes sob hemodiálise, a prevalência da infecção pelo VHC, reconhecida pela presença do seu anticorpo (anti-VHC), varia de 1 a 48%, de acordo com vários estudos (4,14,18,23) .…”

Interferon Therapy for Chronic Hepatitis C in Hemodialysis Patients: Increased Serum Levels of Interferon

“…The recent development of assay methods for hepatitis C virus (HCV) infection has revealed that HCV infections is highly prevalent (11–25%) in patients under maintenance hemodialysis [1, 2, 3, 4, 5]. HCV infection progresses to chronic hepatitis in 50–60% of cases [6], resulting in liver cirrhosis in 20–30 years [7].…”