Hepatitis C virus: Overview of clinical and technical perspectives

Abstract

The increasing incidence/prevalence of hepatitis C virus (HCV) infection in dialysis patients is a cause for concern. In particular, the problem of possible transmission of HCV within a dialysis unit needs to be investigated from both a clinical and technical perspective and substantial evidence generated to support future management. Nosocomial transmission has been repeatedly recognised as a major factor in the spread of HCV. Professional negligence and patient naivety can result in the rapid development of nosocomial infection and research has identified that the incidence of transmission, in environments where parental routes are accessible, is higher. There have been a limited number of investigations into transmission through dialysis equipment and to date this evidence seems to indicate that HCV RNA (cells) do not pass through the dialysis membranes. With so little evidence, there is a need for further clarity. Currently it appears that there is no general agreement about preventative measures. Despite a limited amount of evidence, there appears to be a wide variation in policies concerning the isolation of patients. This article will provide an overview of current clinical and technical research that addresses the management of this virus within the haemodialysis environment. It is also the intention of the author that the article acts as a catalyst to promote interest in an international collaborative research project (CRP), which will be launched by the EDTNA/ERCA Research Board.

Epidemiology and management of Hepatitis C in haemodialysis patients: An informal multidisciplinary review

“…I began with a literature review and telephone enquiries to other renal units. The literature review was fruitful (20), yet both this and the telephone enquiries left me feeling that there were large gaps in both knowledge and data on HCV. I felt that I needed further insight into the incidence and the management of patients who are positive of HCV so I submitted the proposal for the research project.…”