How plausible is transmission of hepatitis C virus via the haemodialysis circuit?

Lindley, Elizabeth; Boyle, Gerry; Gandy, David; Hardy, Andrew; Harrington, Maurice; Hoenich, Nicholas A.; Morgan, Ian Rhys; Thompson, Brett

doi:10.1093/ndtplus/sfr100

Cited by 4 publications

(5 citation statements)

References 5 publications

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“…Besides, its prevalence is significantly high among HD patients, ranging from 7.6 to 13.6% (ELISA (13.6%), RIBA (12.2%), and PCR (7.6%)). Therefore, early detection and management among HD patients should have a high priority due to the high risk of HCV transmission through hemodialysis devices (25,26).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Novel Enzyme-Linked Immuno Assay Model to Detect E2 Antigen and Antibodies Against Core, NS3, NS4, and NS5 Antigens of Hepatitis C Virus

Kheirabad¹,

Nategh²,

Shokri³

et al. 2020

Hepat Mon

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Background: The serological measurement of the anti‐hepatitis C virus antibody is a widely used tool in the first-line diagnosis of HCV infection. Therefore, increasing the testing criteria of these tests is of crucial importance for screening HCV infection. Objectives: The current study aimed to optimize a novel enzyme-linked immuno assay model to detect E2 antigen with or without sample pretreatment in combination with antibodies against core, NS3, NS4, and NS5 antigens of the hepatitis C virus and to compare the performances of these assays with indirect antigen (Ag), biotin/HRP labeled Antigen Sandwich and methods of enzyme-linked immunosorbent assay (ELISA) for their ability to detect HCV. Methods: A total of 107 positive and 415 negative controls from volunteer whole blood donors in Blood Transfusion Organization and 204 blood samples from patients under hemodialysis treatment in Tehran and Bandar Abbas hemodialysis centers are investigated. Six different methods of ELISA test were used to detect anti-HCV antibodies and/or HCV antigens in serum samples. Results: Regarding sensitivity, specificity, and accuracy, E2 Antigen detection alone or combined with antibody detection have the highest accuracy value (99% and 98%, respectively) compared to other methods for antibodies detection. The results of the combined Ag/Ab ELISA test were closer to the results of real-time PCR. Conclusions: This new approach to the detection of antigen and antigen/antibody has better performance criteria concerning the serologic detection of HCV, especially in HD patients who might experience a longer window period.

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Section: Discussionmentioning

confidence: 99%

Evaluation of a Novel Enzyme-Linked Immuno Assay Model to Detect E2 Antigen and Antibodies Against Core, NS3, NS4, and NS5 Antigens of Hepatitis C Virus

Kheirabad¹,

Nategh²,

Shokri³

et al. 2020

Hepat Mon

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“…HCV ribonucleic acid (RNA) has been detected on the hands of nurses dialysing infected patients [30]. Whilst HBV deoxyribonucleic acid (DNA) and HCV RNA have been detected in the dialysate of patients known to have these infections, there is no evidence that the internal fluid pathways offer a viable route for transmission of BBV [31–33].…”

Section: Rationale For Clinical Practice Guidelinesmentioning

confidence: 99%

“…Even in the event of a blood leak, transmission would require HCV to reach fresh dialysate used for a subsequent patient and enter the blood compartment of that patient through back-filtration across the dialyser membrane. This very low theoretical risk of HCV transmission via the haemodialysis circuit could be eliminated altogether by using double transducer protectors for patients who are HCV positive [33]. In isolated cases of HCV transmission a role for the dialysis circuit could not be excluded, but the environmental surfaces are more likely to have contributed to transmission [53].…”

Section: Rationale For Clinical Practice Guidelinesmentioning

confidence: 99%

Clinical practice guideline management of blood borne viruses within the haemodialysis unit

et al. 2019

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Some people who are receiving dialysis treatment have virus infection such as hepatitis B, hepatitis C and/or HIV that is present in their blood. These infections can be transmitted to other patients if blood is contaminated by the blood of another with a viral infection. Haemodialysis is performed by passing blood from a patient through a dialysis machine, and multiple patients receive dialysis within a dialysis unit. Therefore, there is a risk that these viruses may be transmitted around the dialysis session. This documents sets out recommendations for minimising this risk.There are sections describing how machines and equipment should be cleaned between patients. There are also recommendations for dialysing patients with hepatitis B away from patients who do not have hepatitis B. Patients should be immunised against hepatitis B, ideally before starting dialysis if this is possible. There are guidelines on how and when to do this, for checking whether immunisation is effective, and for administering booster doses of vaccine. Finally there is a section on the measures that should be taken if a patient receiving dialysis is identified as having a new infection of hepatitis B, hepatitis C or HIV.

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“…A first option is to use specific monitors for HCV positive patients, without any other isolation measure. As the hydraulic circuit of the monitor plays at most a very small role in transmission, this strategy is unlikely to be beneficial. It may even give HD staff members a feeling of “security,” despite the ongoing risk of transmission from HCV positive patients to other patients dialyzed on adjacent monitors.…”

Section: Introductionmentioning

confidence: 99%

The prevention of hepatitis C virus transmission to hemodialysis patients and staff members

Jadoul

2018

Hemodialysis International

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In this review article, we cover 4 topics very relevant to those involved in the care of hemodialysis (HD) patients and in the management of a HD unit. We start with an overview of the progress made over the last 25 years to reduce hepatitis C virus (HCV) transmission in HD. Next, we discuss the potential strategies to prevent the residual ongoing transmission of HCV to HD patients. Third, we discuss the actions to be taken if a seroconversion for HCV is nevertheless detected in a HD patient. Finally, we briefly discuss how best to protect HD staff members from occupationally acquired HCV infection.

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How plausible is transmission of hepatitis C virus via the haemodialysis circuit?

Cited by 4 publications

References 5 publications

Evaluation of a Novel Enzyme-Linked Immuno Assay Model to Detect E2 Antigen and Antibodies Against Core, NS3, NS4, and NS5 Antigens of Hepatitis C Virus

Evaluation of a Novel Enzyme-Linked Immuno Assay Model to Detect E2 Antigen and Antibodies Against Core, NS3, NS4, and NS5 Antigens of Hepatitis C Virus

Clinical practice guideline management of blood borne viruses within the haemodialysis unit

The prevention of hepatitis C virus transmission to hemodialysis patients and staff members

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