Molecular Evidence of Nosocomial Transmission of Hepatitis C Virus in a Haemodialysis Unit

Abacıoğlu, Yusuf Hakan; Bacaksız, Ferhat; Bahar, I. Hakkı; Simmonds, Peter

doi:10.1007/s100960050456

Cited by 40 publications

(15 citation statements)

References 24 publications

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“…The proportion of HAI which could be prevented by improved decontamination practice is difficult, if not impossible, to estimate. However it is well known that decontamination failures can result in a range of infections 6,7 . It is likely that in many sporadic cases of HAI, the fact that ineffective decontamination has been a contributing factor, will often go unrecognised.…”

Section: Hospital Acquired Infection (Hai)mentioning

confidence: 99%

A quantitative assessment of residual protein levels on dental instruments reprocessed by manual, ultrasonic and automated cleaning methods

Vassey¹,

Budge²,

Poolman³

et al. 2011

Br Dent J

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Section: Hospital Acquired Infection (Hai)mentioning

confidence: 99%

A quantitative assessment of residual protein levels on dental instruments reprocessed by manual, ultrasonic and automated cleaning methods

Vassey¹,

Budge²,

Poolman³

et al. 2011

Br Dent J

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“…Furthermore, the genotyping of HCV isolates is a useful tool in molecular studies carried out to establish the source of outbreaks in hemodialysis centers and other nosocomial settings (4,5).…”

mentioning

confidence: 99%

“…Phylogenetic analysis of this region could be useful to identify the route of HCV transmission, e.g., in the detection of HCV subtype(s) implicated in nosocomial transmission (4,15).…”

mentioning

confidence: 99%

Genotyping hepatitis C virus from hemodialysis patients in Central Brazil by line probe assay and sequence analysis

Espírito-Santo

Carneiro

Reis

et al. 2007

Braz J Med Biol Res

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The present study examined the distribution of hepatitis C virus (HCV) genotypes and subtypes in a hemodialysis population in Goiás State, Central Brazil, and evaluated the efficiency of two genotyping methods: line probe assay (LiPA) based on the 5' noncoding region and nucleotide sequencing of the nonstructural 5B (NS5B) region of the genome. A total of 1095 sera were tested for HCV RNA by RTnested PCR of the 5' noncoding region. The LiPA assay was able to genotype all 131 HCV RNA-positive samples. Genotypes 1 (92.4%) and 3 (7.6%) were found. Subtype 1a (65.7%) was the most prevalent, followed by subtypes 1b (26.7%) and 3a (7.6%). Direct nucleotide sequencing of 340 bp from the NS5B region was performed in 106 samples. The phylogenetic tree showed that 98 sequences (92.4%) were classified as genotype 1, subtypes 1a (72.6%) and 1b (19.8%), and 8 sequences (7.6%) as subtype 3a. The two genotyping methods gave concordant results within HCV genotypes and subtypes in 100 and 96.2% of cases, respectively. Only four samples presented discrepant results, with LiPA not distinguishing subtypes 1a and 1b. Therefore, HCV genotype 1 (subtype 1a) is predominant in hemodialysis patients in Central Brazil. By using sequence analysis of the NS5B region as a reference standard method for HCV genotyping, we found that LiPA was efficient at the genotype level, although some discrepant results were observed at the subtype level (sensitivity of 96.1% for subtype 1a and 95.2% for subtype 1b). Thus, analysis of the NS5B region permitted better discrimination between HCV subtypes, as required in epidemiological investigations.

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“…Hemodialysis is known to be a risk factor for Hepatitis C virus (HCV) transmission despite screening of blood products for HCV antibodies (anti-HCV) and the use of erythropoietin (1). Nosocomial transmission of the HCV has become the principal cause of HCV infection in hemodialysis units (10-12, 14, 20, 21).…”

mentioning

confidence: 99%

Use of Phylogenetic Analysis of Hepatitis C Virus (HCV) Hypervariable Region 1 Sequences To Trace an Outbreak of HCV in an Autodialysis Unit

et al. 2002

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Hemodialysis patients are at high risk of infection by hepatitis C virus (HCV). The aim of this study was to investigate an HCV outbreak that occurred in an autodialysis unit by using epidemiological and molecular methods. Seroconversion to HCV antibody (anti-HCV) was observed in two patients over an 18-month period; two other patients had previously been recorded as anti-HCV positive. All four patients involved in the outbreak were tested for HCV RNA, and hepatitis C genotype determination was accomplished by a reverse hybridization assay. Furthermore, part of hypervariable region 1 (HVR1) of the hepatitis C genome was amplified and sequenced in samples from all HCV RNA-positive patients. Phylogenetic analysis of the nucleotide sequences obtained was carried out in order to investigate any possible epidemiological linkages among patients. The nucleotide sequences of the HVR1 regions of both newly infected patients were found to be identical to sequences of samples from previously recorded anti-HCV-positive original patients, suggesting that they were infected by the same isolate. Molecular and epidemiological analysis suggested that nosocomial patient-to-patient transmission was the most likely explanation for the virus spread in the autodialysis unit under study.Hemodialysis is known to be a risk factor for Hepatitis C virus (HCV) transmission despite screening of blood products for HCV antibodies (anti-HCV) and the use of erythropoietin (1). Nosocomial transmission of the HCV has become the principal cause of HCV infection in hemodialysis units (10-12, 14, 20, 21). Such transmission occurs through direct patientto-patient contact more often than through HCV-contaminated dialysis monitors (13). There remains a relatively high incidence of new infections in hemodialysis units, mainly through cross-contamination from HCV hemodialysis patients (8,17). The prevalence of infection increases with the duration of dialysis treatment, independent of transfusion events (5, 6). The exact mechanism of the route of this contamination is rarely known, and the causal events that lead to the outbreak cannot generally be traced (15). These cases of nosocomial transmission seem to have occurred despite strict general hygiene precautions. The prevalence of HCV infections is not declining, and transmission in dialysis units is continuing. Adequate screening of HCV infections and strict enforcement of universal infection control practices are required (9). Home dialysis and autodialysis were developed as alternatives to hemodialysis centers, and there have been fewer reported HCV infections in the former than in the latter (17).HCV, like other RNA viruses, exhibits enormous genomic diversity. HCV isolates show four levels of genetic variability: types, subtypes, isolates, and quasispecies. This heterogeneity is a consequence of high error rates in RNA replication. HCV circulates as a heterogeneous population of genetically different but closely related genomes known as the quasispecies (2).Hypervariable region 1 (HVR1) of the gen...

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Molecular Evidence of Nosocomial Transmission of Hepatitis C Virus in a Haemodialysis Unit

Cited by 40 publications

References 24 publications

A quantitative assessment of residual protein levels on dental instruments reprocessed by manual, ultrasonic and automated cleaning methods

A quantitative assessment of residual protein levels on dental instruments reprocessed by manual, ultrasonic and automated cleaning methods

Genotyping hepatitis C virus from hemodialysis patients in Central Brazil by line probe assay and sequence analysis

Use of Phylogenetic Analysis of Hepatitis C Virus (HCV) Hypervariable Region 1 Sequences To Trace an Outbreak of HCV in an Autodialysis Unit

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