Incidence and risk factors for hepatitis C seroconversion in hemodialysis: A prospective study

Abstract

To delineate the incidence and risk factors for seroconversion (SC) for HCV, from May 1991 to November 1992 we followed all 401 patients (no i.v. drug abusers) dialyzed in 15 Belgian hemodialysis (HD) units, none of which isolates anti-HCV (+) patients. The sensitive ELISA II test was performed in the same laboratory for all patients. ELISA II (+) sera were considered truly positive if specific antibodies were detected by RIBA II against at least one HCV antigen. Blood transfusions given from 12 months prior to inclusion in the study, dialyzer reuse and frequency of dialysis monitor sterilization were recorded. In May 1991, prevalence of truly positive ELISA II tests averaged 13.5% (54/399). During the three consecutive six-month periods, ELISA II became truly positive in 3 of 305 (1%), 4 of 314 (1.3%) and 1 of 313 (0.3%) patients, respectively, which was an average yearly incidence of 1.7%. SC was preceded (1 to 6 months) in all cases by an unexplained, unprecedented increase in the alanine aminotransferase level. The mean monthly rate of transfusions was significantly higher (P < 0.001) in eight patients with SC (0.7 +/- 0.6 U) than in 393 patients without SC (0.1 +/- 0.01 U). However, three of eight patients with SC had not been transfused at all. SC was observed in only 3 of 13 units (1, 3 and 4 cases, respectively) dialyzing ELISA (+) patients. In the unit with three SC, patients were always assigned a fixed station: SC was observed only in patients dialyzed next to an ELISA II (+) patient (3 of 8 vs. 0 of 30, P < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Hepatitis C in hemodialysis: the contribution of injection drug use

“…44 This author also points out that drug use seems to be less important in European samples, as shown in studies conducted in Germany, France, and Belgium, where injection drug use was not a risk factor for HCV infection in patients on HD. 37,49,52 No similar reports analyzing this association in Latin American patients could be retrieved in our literature review.…”

Hepatitis C risk factor for patients submitted to dialysis

“…In the clinic where our study was conducted, the HCV (+) patients are not placed in different rooms, but in separate sides attempting, therefore, to reduce the nosocomial transmission chance. The individualization of dialysis machinery is not recommended; however, there suggested strict measures for universal precaution, in addition to the extreme attention to the sterilization of the dialysis machinery [25][26][27][28], as according to the literature, the cross-infection by HCV is due to the disregard to the universal precautions and the absence of severe standardization that meets the specifications of each situation.…”

Prevalência e fatores associados à hepatite C em pacientes de hemodiálise

“…Observou-se que 33% dos pacientes não transfundidos previamente eram reagentes ao anti-VHC. Tal observação sugere que outros fatores estejam também envolvidos na transmissão de hepatite C nessa população, como foi relatado por Jadoul et al 12 (1993) e Corcoran et al 6 (1994).…”