Prevention of Hepatitis C Virus in Dialysis Units

Abstract

To understand how to prevent the diffusion of hepatitis C virus (HCV) in dialysis units, 289 chronic dialysis patients treated in a renal department from the beginning of 1990 to June 30, 1993, were studied. Patients were screened monthly for alanine aminotransferase values and every 3 months for anti-HCV antibodies. At the beginning of the study the prevalence of anti-HCV antibodies was 24.7%. Two study groups were defined. In the first, anti-HCV-positive patients were treated on separate machines; in the second, 13 anti-HCV-positive and 13 negative patients shared the same machines. Patients in the study were treated with traditional dialysis, employing low-permeability membranes and disposable dialysate circuits on machines without an ultrafitration control device. The ‘universal precautions’ were rigorously applied. The use of blood transfusions was markedly reduced. Although new patients starting dialysis treatment revealed a high frequency of HCV positivity (10.8%), the overall prevalence of HCV infection in the department did not increase during the follow-up period. Furthermore, no seroconversion was found in patients on dialysis treatment, not only in the section where anti-HCV-positive patients were treated on separate machines, but also in the section where anti-HCV-positive and anti-HCV-negative patients shared the same machines. The possibility of an intradialytic diffusion of HCV appeared to be very low and the treatment of infected patients on separate machines not strictly necessary.

Prevalence and Incidence of Hepatitis C Virus in Hemodialysis Patients in British Columbia: Follow‐up after a Possible Breach in Hemodialysis Machines

“…Despite modern infection control policies (20,21), hepatitis transmission is still reported in hemodialysis centres (22,23). All hemodialysis units in BC follow formal infection control policies (24), which recommend anti-HCV testing before dialysis initiation and every six months thereafter.…”

Prevalence and risk factors of hepatitis C virus infection in hemodialysis patients from one center in Recife, Brazil

“…A very important role must be attributed to the scrupulous and strict application of universal precautions (Gilli et al 1995) to reduce of environmental diffusions of C hepatitis in dialysis units. A genuine transmission could be caused by the leakage of blood or blood components through the dialysis filter.…”

Effect of Isolation Measures on the Incidence and Prevalence of Hepatitis C Virus Infection in Hemodialysis

“…Compliance with universal precautionary measures could be enough to prevent nosocomial transmission, as has been shown by several authors [8, 9] and as is recommended by the CDC [10]. Yet others propose rigorous implementation of universal precautionary measures and, in addition, isolation of HCV+ patients in restricted areas of the dialysis rooms, with exclusive dialysis equipment and nurses [11].…”