Hepatitis C virus infection in 2,744 hemodialysis patients followed regularly at nine centers in Hiroshima during November 1999 through February 2003

Abstract

Patients on maintenance hemodialysis (HD) are at increased risk of infection with hepatitis C virus (HCV). A prospective follow-up study on HCV infection from November 1999 to February 2003 was conducted in nine hemodialysis (HD) units in Hiroshima. A total of 2,744 HD patients were surveyed regularly for HCV RNA in serum. The prevalence of HCV RNA decreased from 15.7% (262/1,664) on the first survey to 12.9% (242/1,882) in the last one (P<0.05). This decrease may be attributed to the inclusion of patients with a lower prevalence of HCV RNA compared to patients leaving dialysis centers (111/1,080 [10.3%] vs. 132/862 [15.3%], P<0.01). During the 40 months of this study, 16 de novo HCV infections were documented in the nine HD units corresponding to an incidence of 0.33% per year. These cases included eight new HCV infections, three re-infections, and five infections that presumably occured in the window period when tested during the first survey. Our study shows that the annual incidence of de novo HCV infection during HD was 0.33%, and emphasizes the need for frequent serum HCV RNA testing and for stringent disinfection procedures in order to prevent the transmission of HCV in these settings.

Clinical significance of alanine aminotransferase levels and the effect of ursodeoxycholic acid in hemodialysis patients with chronic hepatitis C

“…In addition, the basal or clinical course of ALT levels appears to predict decreased PLT or thrombocytopenia in patients with HCV. In this study population, the prevalence [243 anti-HCV positive among 2539 HD patients (9.6%)] and age distribution (average age was 63 years old) of anti-HCV antibody-positive subjects and the frequency of the HCV serotype I (74%) were similar to previous reports on HD patients with HCV in Japan [24][25][26], suggesting that the clinical course of anti-HCV-positive subjects in this study reflects those in Japan as a whole. It is known that patients on HD often have thrombocytopenia [27], and there is a negative correlation between the dialysis period and PLTs [27,28].…”

Hepatitis C in hemodialysis: the contribution of injection drug use

“…39,41,42 Duration on HD has been described as the main independent risk factor for HCV infection, 2,3,21,35,[43][44][45] and each additional year on HD represents an increase of 10% to 13% in the risk of infection. 5,46 In this study being on HD longer than fi ve years was an independent risk factor for infection, which is in agreement with fi ndings reported in other studies.…”

Hepatitis C in Hemodialysis Patients: Current Global Magnitude, Natural History, Diagnostic Difficulties, and Preventive Measures

“…Those studies that prospectively followed HD patients for their HCV status presented an annual incidence rate of de novo HCV infection of 0.4% in France [79], 0.5% in Tunisia [65], 0.5% in the Netherlands [52], 0.83% in Italy [50], 1.38% [80] and 2.1% [81] in the USA, 0.33% [28], 2.59% [30], and 3.1% in Japan [82], 3.7% [72] and 5.5% [69] in Brazil, and 6.2% in Greece [46]. …”