Results of a national epidemiological investigation of HCV infection in dialysis patients

Lombardi, Marco; Cerrai, T; Geatti, Sandro; Negroni, Silvia; Pertusini, Laura; Pegoraro, Marisa; Lullo, Gloria A. Di

doi:10.1111/j.1755-6686.1999.tb00048.x

Cited by 13 publications

(14 citation statements)

References 4 publications

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“…17 The small but definite incidence of acute HCV infection detected in chronic HD patients in developed countries, after the elimination of post-transfusion HCV infection, also supports HCV transmission by nosocomial routes. 12,13,18 Several mechanisms could potentially contribute to nosocomial HCV transmission between hemodialysis patients: dialyzer reuse, internal contamination of hemodialysis machines, and contamination of the hands of staff members or of items shared between patients. The relationship between dialyzer reuse and anti-HCV positivity has been confirmed in some 19 but not all studies.…”

Section: Transmission Of Hcv Within Hemodialysis Unitsmentioning

confidence: 99%

Hepatitis C infection and the patient with end-stage renal disease

2002

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Hepatitis C virus (HCV) remains common in patients with end-stage renal disease (ESRD)and is an important cause of liver disease in this population. Acquisition of HCV infection continues to occur in dialysis patients because of nosocomial spread. The natural history of HCV in dialysis patients remains controversial because the course of HCV typically extends over decades, whereas dialysis patients have higher morbidity and mortality rates than those of the general population limiting long-term follow-up. However, recent reports suggest that HCV infection affects the survival of chronic dialysis patients as well as renal transplant ( L iver disease is a significant cause of morbidity and mortality in patients with end-stage renal disease (ESRD) treated by dialysis or transplantation. 1 Viral hepatitis was suspected to be prevalent in patients with ESRD maintained on chronic hemodialysis (HD) nearly 3 decades ago. Development of diagnostic testing for hepatitis B virus (HBV) confirmed a high incidence and prevalence of HBV infection both in patients and staff in HD units. A number of measures mandated by the Centers for Disease Control, including isolation of hepatitis B surface antigen-positive patients, dedicated dialysis machines, and regular surveillance for HBV infection, dramatically reduced the spread of HBV in this setting by the late 1970s. However, many cases of liver disease in ESRD were unexplained and were ascribed to non-A, non-B hepatitis. Once the hepatitis C virus (HCV) was cloned, 2 it rapidly became evident that HCV was frequent in patients with ESRD on HD and that HCV transmission was occurring within HD units in the absence of the usual parenteral risk factors (i.e., blood transfusion or illicit drug use) ( Table 1). A number of other important facets of HCV infection in ESRD patients have been recognized, including false-negative serologic tests and an absence of biochemical dysfunction despite viremia. However, despite this, progressive liver disease can occur and is a particular concern in the patient who is a renal transplantation (RT) recipient. Epidemiology and Diagnosis of HCV Infection in ESRDWith first-and second-generation serologic testing for HCV available, a number of investigators 3 reported a high prevalence of anti-HCV seropositivity in patients with ESRD on chronic dialysis, most of whom were also viremic by polymerase chain reaction (PCR). A high rate of false-negative serologic testing was also noted. Bukh et al. 4 reported that 2.6% of dialysis patients seronegative by second-generation enzyme-linked immunosorbent assay (ELISA) were viremic by PCR. However, the more recent

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Section: Transmission Of Hcv Within Hemodialysis Unitsmentioning

confidence: 99%

Hepatitis C infection and the patient with end-stage renal disease

2002

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“…The reported prevalence of hepatitis C virus (HCV) infection ranges from 8 to 20% in dialysis patients receiving maintenance dialysis in the developed world; [1][2][3][4][5] the frequency of HCV is much higher in patients undergoing dialysis in less-developed countries. [6][7][8][9][10][11][12][13][14] Recent studies have shown that HCV is an important cause of morbidity and mortality in chronic dialysis patients.…”

Section: Introductionmentioning

confidence: 99%

Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients

Fabrizi

Dulai²,

Dixit

et al. 2003

Aliment Pharmacol Ther

145

129

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SUMMARYBackground: The efficacy of interferon monotherapy in dialysis patients with chronic hepatitis C remains unclear, although a number of small clinical trials have been published addressing this issue. Methods and aims: We evaluated the efficacy and safety of initial interferon monotherapy in dialysis patients with chronic hepatitis C by performing a systematic review of the literature with a meta-analysis of clinical trials. The primary outcome was sustained virological response (as a measure of efficacy); the secondary outcome was drop-out rate (as a measure of tolerability). We used the random effects model of Der Simonian and Laird, with heterogeneity and sensitivity analyses. Results: We have identified 14 clinical trials (269 unique patients); two were controlled studies. The mean overall estimate for sustained virological response (SVR) and drop-out rate was 37% [95% confidence interval (CI) 28-48] and 17% (95% CI 10-28),

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“…Their number was significantly higher in the HCV positive group. It is a result opposite to what was reported in the literature, especially in the DOPPS study, prevalence and risk of seroconversion were lower in dialysis units with a large number of experienced nurses [32][33][34][35][36]. This result could be explained by the lack of training for experienced nurses leading to a relaxation of the application of universal rules of hygiene, even if a correlation was found between the number of chronic hemodialysis and the number of nurses Experienced (correlation coefficient 0.54, p=0.03).…”

Section: Factors Prevalence Of Hepatitis C Virus In Hemodialysismentioning

confidence: 86%

Hepatitis C Viral Prevalence and Seroconversion in Moroccan Hemodialysis Units: Eight Year Follow Up

Omar¹

2013

J Med Diagn Meth

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Introduction: The prevalence of Hepatitis C Virus (HCV) in chronic hemodialysis patients is eight times higher than among the general population. It is estimated between 3 and 65.8% in different studies and countries and is a contributor to mortality in this population. The aim of this study is to define the factors influencing prevalence and seroconversion of HCV in an ambispective study including 15 centers and 163 hemodialysis patients.Methods: Multicenter ambispective Study including 167 patients treated in 15 dialysis centers in 4 cities and over a period of 8 years. In 2002, all patients underwent determination of liver enzymes, a serological survey and qualitative research of HCV RNA by polymerase chain reaction followed by a genotyping for patients confirmed positive by the method LIPA. Serological status and movement of patients between centers was followed for 8 years. In 2010, the survivors benefit serology of viral hepatitis B and C (4 th generation ELISA) with research of viral RNA by PCR. Results:The mean age of patients at baseline was 51 years of which 11% were diabetic with a mean of 55 months on hemodialysis. The prevalence of HCV was 33.4% with significantly higher ALT in positive patients and genotype 1b was most frequent (54%). Statistical analysis found that the factors of prevalence are: time on hemodialysis, number of units visited (2.2 vs. 3, p<0.001), number of red blood cells transfused (1.5 vs. 2.5, p=0.009) and area of the unit. After 8 years, overall survival was 58.2% with a prevalence of HCV at 26.2%. During follow-up, 7 seroconversion were objectified and the only factor found is the number of centers visited.Conclusions: These data suggest that nosocomial transmission plays an important role hence the importance of strict implementation of the recommendations of prevention against the transmission of HCV in particular the training of personnel and control the transfer of patients between centers.Keywords: Hemodialysis; Hepatitis C virus; Prevalence; Seroconversion Introduction:Hepatitis C virus (HCV) infection represents a big public health challenge in this millennium and the World Health Organization estimates that, until 1998, 170 million people carried the HCV worldwide and in recent years 200 million or 3% of the world population is infected with this virus [1]. Low prevalence is reported in Europe and North America, while it's high in the Far East and Africa where the prevalence exceeds 10% in Egypt. In Morocco, a recent study showing that among the 8326 samples tested by third generation ELISA, 161 samples were positive, so a prevalence of 1.93% [2].In dialysis the problem is much broader, with a prevalence that can reach 80% and an incidence of more than 9% per year [3][4][5][6]. To this is added a high mortality in hemodialysis patients infected with HCV according to many authors [7][8][9][10]. In Morocco it is estimated that the prevalence of hepatitis C virus in dialysis is 32% according to the National Register "MAGREDIAL [4]. But this rate varies widely amon...

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Results of a national epidemiological investigation of HCV infection in dialysis patients

Cited by 13 publications

References 4 publications

Hepatitis C infection and the patient with end-stage renal disease

Hepatitis C infection and the patient with end-stage renal disease

Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients

Hepatitis C Viral Prevalence and Seroconversion in Moroccan Hemodialysis Units: Eight Year Follow Up

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