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[Hepatitis C virus infection among long-term hemodialysis patients]
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Hepatitis C virus (HCV) infection is prevalent in hemodialysis patients, with a 32.5% infection rate. Key risk factors include transfusions, long-term dialysis, and contaminated equipment, necessitating patient isolation.
Area of Science:
- Infectious Diseases
- Nephrology
- Virology
Background:
- Hepatitis C virus (HCV) poses a significant risk to immunocompromised populations.
- Hemodialysis patients are particularly vulnerable due to frequent medical interventions.
Purpose of the Study:
- To determine the prevalence and incidence of HCV infection in hemodialysis patients.
- To identify risk factors associated with HCV transmission in this cohort.
Main Methods:
- Serum samples from 80 hemodialysis patients and 30 controls were tested for HCV antibodies (ELISA) and RNA (PCR).
- Retesting was performed after three months to assess incidence.
- Statistical analysis (Mantel-Haenszel) identified risk factors.
Main Results:
- The overall HCV infection rate among hemodialysis patients was 32.5%.
- Significant risk factors included multiple transfusions, prolonged dialysis duration, renal transplantation, and history of surgery.
- HCV RNA was detected in dialysate samples from infected patients.
Conclusions:
- HCV infection rates are elevated in hemodialysis patients compared to the general population.
- Hemodialysis procedures, blood transfusions, and contaminated equipment are major transmission routes.
- Isolation of infected patients and stringent infection control measures are crucial.
Abstract:
We determined the prevalence and incidence of hepatitis C virus (HCV) infection among hemodialysis patients and evaluate their risk factors. 80 patients on maintenance hemodialysis in Peking Union Medical College Hospital Dialysis Center from December 1994 to June 1995 were studied. 30 medical students were used as health controls. Serum samples were tested for HCV antibodies by a second-generation enzyme-linked immunosorbent assay (ELISA) and for HCV RNA using nested polymerase chain reaction (PCR) and retested for anti-HCV and HCV RNA three months later. 24 (30%) of 80 hemodialysis patients were anti-HCV positive, and 2 (3.6%) of 56 anti-HCV negative cases were found HCV RNA positive. By combined assessment, the HCV infection rate of hemodialysis patient was 32.5% (26/80). Mantel-Haenszel analysis showed that HCV infection was associated with multi-transfusions, dialysis over a long period, renal transplantation, history of operation. Samples of dialysate in 9 serum HCV RNA positive cases were directly detected for HCV RNA, and 3 were found HCV RNA detectable. HCV infection rate in hemodialysis patients is higher than that of general population. The main risk factors for HCV transmission is transfusion of unscreened blood but is not an independent factor, hemodialysis itself plays an important role, the length of time on dialysis, renal transplantation, blood-contaminated material and contaminated dialysis equipment are also the risk factors. Infected hemodialysis patients should be isolated.