Epidemiology of hepatitis C virus infection in chronic haemodialysis

Abstract

There is a high prevalence of hepatitis virus infection in haemodialysis patients (17.7% of patients on the EDTA registry). That prevalence varies according to countries with a North-South gradient but also according to institutions or to the mode of treatment: haemodialysis in a unit or at home, peritoneal dialysis. Post-transfusional contamination was the number one risk factor before 1991. The incidence of infection in haemodialysis units is also variable, which reveals the risk of nosocomial transmission between patients. Strict observance of universal precautions against nosocomial infections reduces the contamination risk. The relevancy of separating patients is controversial. Other risk factors exist in haemodialysis patients, especially in those with heavier medical records, multiple surgery, endoscopy. Diagnostic anti-HCV antibody screening has improved in terms of specificity and sensitivity. HCV RNA detection by PCR confirms that most HCV antibody-positive patients are also viraemic and potentially contaminant; it permits detecting recent contamination. Virus genotyping is epidemiologically relevant because it offers the possibility to trace infections, and may also have therapeutical interest. Prevalence is greater in personnel than in the general population, which underlines the necessity to observe universal precautions.

Hepatitis C Infection and Related Factors in Hemodialysis Patients in China: Systematic Review and Meta-Analysis

“…There were differences about the prevalence of hepatitis C virus reported in various countries and regions. HCV infection rate was 12.0-25.0% in European HD patients with an average of 17%, [58] the United States 7.6%, [59] and Taiwan 61%. [39] Dramatic geographic differences in pooled HCV infection rates among HD patients have been observed.…”

Effect of Dialysis Modality on Survival of Hepatitis C-Infected ESRF Patients

“…The postulated reasons for this observation include reduced blood transfusion requirements in PD patients (3,(15)(16)(17) and the more isolated practice of dialysis at home with minimized visits to the renal unit (every 1 to 3 months for PD rather than thrice weekly for HD) (2). Furthermore, a number of studies suggest that environmental transmission within dialysis units is a major risk factor for HCV transmission in HD patients (4,14,15). PD may therefore be an attractive option for ESRF patients with HCV infection to minimize transmission to other patients, provided survival was at least comparable to that of HD.…”

Hépatites virales chroniques chez les patients insuffisants rénaux

“…Elle est de 25 % aux États-Unis [10], de 68 % en Arabie Saoudite [11], de 13,5 % en Europe [12] et de 20 % en Tunisie [13]. La prévalence est significativement associée à la durée de l'hémo-dialyse et aux nombres d'unités de produits sanguins transfusés [14,15]. D'autres facteurs de risque ont été rapportés dans certaines études : le sexe masculin [11,14] et l'infection par d'autres virus, en particulier le virus de l'immunodéficience humaine (VIH) et le VHB [11].…”