Universal precautions prevent hepatitis C virus transmission: A 54 month follow-up of the Belgian multicenter study

Abstract

The isolation of anti-hepatitis C virus (HCV) in hemodialyzed (HD) patients has been repeatedly advocated to prevent nosocomial HCV transmission. We evaluated the incidence of seroconversion for HCV in Belgian HD patients, and demonstrate the complete prevention of HCV transmission by adherence to the universal precautions advocated by the Centers for Disease Control (Atlanta, GA, USA). All (N = 963) HD patients from 15 units, none of which isolates anti-HCV positive patients, were tested by a second or third generation enzyme-linked immunosorbent assay (with confirmation by a second- or third-generation recombinant immunoblot assay or the polymerase chain reaction) every 18 months from May 1991 to November 1995. Follow-up was available in 488 patients (drop-outs resulting from death or transplantation mainly). The yearly incidence of seroconversion for HCV over the initial 18 months was 1.41%, with evidence suggestive of nosocomial HCV transmission. Universal precautions were therefore reinforced. The incidence of seroconversion subsequently fell to 0.56% and 0%, respectively (P = 0.014), despite the facts that the average transfusion load and the proportion of patients with dialyzer reuse or with monitors disinfected after each session did not change significantly. We conclude that the strict enforcement of universal precautions fully prevents HCV transmission to HD patients. The isolation of anti-HCV positive patients is not warranted.

Hepatitis C risk factor for patients submitted to dialysis

“…In our research, we verified a high frequency of male patients of 59%, corroborating with other projects in the literature [8,[19][20][21] that also demonstrate the absence of association between the gender, age, and the infection of HCV in dialysed patients [17]. As in other studies, we did not find association between the base disease and the frequency of infection by the hepatitis C virus [16,17].…”

“…In our study, we found an inferior value to the ones verified in the Brazilian studies as well as the ones from Santa Catarina State with 16.8 % of the cases of hepatitis C, despite being low, it is still worrying. The found value may be due to a decrease in the Hepatitis C prevalence already observed in other studies or it refers to reduction of the HCV infection after blood transfusion as consequence of the introduction of control measures to prevent the nosocomial transmission [18,19].…”

Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients

“…The reported prevalence of hepatitis C virus (HCV) infection ranges from 8 to 20% in dialysis patients receiving maintenance dialysis in the developed world; [1][2][3][4][5] the frequency of HCV is much higher in patients undergoing dialysis in less-developed countries. [6][7][8][9][10][11][12][13][14] Recent studies have shown that HCV is an important cause of morbidity and mortality in chronic dialysis patients.…”

Incidência de hepatite viral C em pacientes em hemodiálise no Brasil entre 2000 e 2003

“…Além disso, o uso mais disseminado da eritropoetina levou a uma redução do número de hemotransfusões nessa população. Consequentemente, o interesse voltou-se para a discussão de estratégias visando à redução da transmissão do HCV entre os pacientes nos centros de diálise, a qual pode ocorrer por quebra das rotinas de precauções universais 5,6 .…”