A twelve year natural history of hepatitis C virus infection in hemodialyzed patients

Simon, Nicole; Couroucé, Anne‐Marie; LeMarrec, N.; Trépo, C.; Ducamp, Stéphane

doi:10.1038/ki.1994.301

Cited by 122 publications

(83 citation statements)

References 30 publications

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“…11 Although the duration of anti-HCV positivity in these patients is not precisely known, it is likely to be short, as shown by the lack of cirrhosis, mild liver histologic findings, and the known risk of seroconversion to anti-HCV positive state while on hemodialysis in the absence of blood transfusion. 12,13 Our results of genotyping are in keeping with other reports that showed that type 1b and 4 are the predominant genotypes in this part of the world.…”

Section: Discussionsupporting

confidence: 80%

Anti-HCV Positive Hemodialysis Patients: Clinical, Biochemical, Histologic and Virologic Study and a Proposed Management Scheme

et al. 2000

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Section: Discussionsupporting

confidence: 80%

Anti-HCV Positive Hemodialysis Patients: Clinical, Biochemical, Histologic and Virologic Study and a Proposed Management Scheme

et al. 2000

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“…The results from molecular biology investigations and epidemiological evaluation are complementary pieces of evidence for possible nosocomial transmission of HCV (16,18,19). This case emphasizes the risk of transmission and the importance of infection control procedures in hemodialysis units (22). It also highlights the usefulness of molecular epidemiological techniques for the investigation of outbreaks of HCV infection.…”

mentioning

confidence: 96%

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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“…Prospective studies mono-centric and multicenter helped establish the incidence of HCV seroconversion in hemodialysis [32,[37][38][39][40][41][42][43]. The annual incidence varies between studies and countries with low or zero rate in developed countries, and over 10% in emerging countries.…”

Section: The Seroconversion Of Hepatitis C Virus In Hemodialysismentioning

confidence: 99%

Hepatitis C Viral Prevalence and Seroconversion in Moroccan Hemodialysis Units: Eight Year Follow Up

Omar¹

2013

J Med Diagn Meth

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Introduction: The prevalence of Hepatitis C Virus (HCV) in chronic hemodialysis patients is eight times higher than among the general population. It is estimated between 3 and 65.8% in different studies and countries and is a contributor to mortality in this population. The aim of this study is to define the factors influencing prevalence and seroconversion of HCV in an ambispective study including 15 centers and 163 hemodialysis patients.Methods: Multicenter ambispective Study including 167 patients treated in 15 dialysis centers in 4 cities and over a period of 8 years. In 2002, all patients underwent determination of liver enzymes, a serological survey and qualitative research of HCV RNA by polymerase chain reaction followed by a genotyping for patients confirmed positive by the method LIPA. Serological status and movement of patients between centers was followed for 8 years. In 2010, the survivors benefit serology of viral hepatitis B and C (4 th generation ELISA) with research of viral RNA by PCR. Results:The mean age of patients at baseline was 51 years of which 11% were diabetic with a mean of 55 months on hemodialysis. The prevalence of HCV was 33.4% with significantly higher ALT in positive patients and genotype 1b was most frequent (54%). Statistical analysis found that the factors of prevalence are: time on hemodialysis, number of units visited (2.2 vs. 3, p<0.001), number of red blood cells transfused (1.5 vs. 2.5, p=0.009) and area of the unit. After 8 years, overall survival was 58.2% with a prevalence of HCV at 26.2%. During follow-up, 7 seroconversion were objectified and the only factor found is the number of centers visited.Conclusions: These data suggest that nosocomial transmission plays an important role hence the importance of strict implementation of the recommendations of prevention against the transmission of HCV in particular the training of personnel and control the transfer of patients between centers.Keywords: Hemodialysis; Hepatitis C virus; Prevalence; Seroconversion Introduction:Hepatitis C virus (HCV) infection represents a big public health challenge in this millennium and the World Health Organization estimates that, until 1998, 170 million people carried the HCV worldwide and in recent years 200 million or 3% of the world population is infected with this virus [1]. Low prevalence is reported in Europe and North America, while it's high in the Far East and Africa where the prevalence exceeds 10% in Egypt. In Morocco, a recent study showing that among the 8326 samples tested by third generation ELISA, 161 samples were positive, so a prevalence of 1.93% [2].In dialysis the problem is much broader, with a prevalence that can reach 80% and an incidence of more than 9% per year [3][4][5][6]. To this is added a high mortality in hemodialysis patients infected with HCV according to many authors [7][8][9][10]. In Morocco it is estimated that the prevalence of hepatitis C virus in dialysis is 32% according to the National Register "MAGREDIAL [4]. But this rate varies widely amon...

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A twelve year natural history of hepatitis C virus infection in hemodialyzed patients

Cited by 122 publications

References 30 publications

Anti-HCV Positive Hemodialysis Patients: Clinical, Biochemical, Histologic and Virologic Study and a Proposed Management Scheme

Anti-HCV Positive Hemodialysis Patients: Clinical, Biochemical, Histologic and Virologic Study and a Proposed Management Scheme

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

Hepatitis C Viral Prevalence and Seroconversion in Moroccan Hemodialysis Units: Eight Year Follow Up

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