Travel-associated acquisition of hepatitis C virus infection in patients receiving haemodialysis

Abstract

Among haemodialysis patients in the United Kingdom, antibody-negative/RNA-positive HCV status is associated with newly acquired infection, rather than lack of antibody responses in chronic HCV infection. There is a significant risk of HCV infection associated with travel to resource-limited countries. Given that transaminase levels may be normal, HCV RNA testing is recommended in patients re-entering a dialysis unit following haemodialysis in settings where suboptimal infection control policies pose a risk of exposure to blood-borne viruses.

Antibodies to Core Antigen of Hepatitis B Virus in Patients on Renal Replacement Therapy: Association with Demographic, Clinical and Laboratory Data

“…HCV RNA was detected in 52–93% of anti-HCV-positive dialysis patients [10,35,36]. In our study, it was 60.6% of cases, which is the most close to the finding of Ghafur et al (58.3%) [36].…”

“…Additionally, HCV RNA was shown in 0.23% of anti-HCV-negative patients. In other studies, among anti-HCV-negative subjects, 0.4–12% tested HCV RNA positive [10,35,36,37,38]. …”

Holiday haemodialysis and imported hepatitis C virus infection: A series of sixteen cases in two large haemodialysis units

“…A recent report from London documents two patients who after haemodialysis in the Indian Subcontinent contracted HCV infection. 3 Our report documents sixteen such cases. The increased incidence of holiday haemodialysis acquired HCV infections after 2006 is likely to be resulting from increased frequency of travel by the patients to high-risk areas.…”

“…1,2 It is likely that patients are at increased risk of acquiring a blood borne virus infection when taking holiday haemodialysis in countries where these viruses have high prevalence and where standards of infection control are inadequate. [3][4][5][6][7] About 30% of the Birmingham City's population are from a minority ethnic groups 8 (mostly from the Indian Subcontinent as well as Afro-Caribbean), and dialysis units in Birmingham hospitals have a significant number of patients from these groups. In the last few years an increasing number of our haemodialysis patients started taking holidays in their country of origin mainly in the Indian Subcontinent.…”

Hepatitis C virus infection in haemodialysis and kidney transplant patients

“…There is a significant risk of developing HCV infection in these travellers. A recent prospective surveillance of 131 such dialysis patients reentering their haemodialysis units showed a HCV incidence of 4/153 travel episodes (2.6%) [40]. Therefore, enhanced surveillance using HCV RNA testing (followed by antibody testing) and standard isolation protocols are required for these returning travellers until they have exceeded the incubation period of HCV.…”