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Hepatitis C virus in dialysis units: a multicenter study
A Da Porto1, A Adami, F Susanna
1Department of Nephrology, General Hospital, Treviso, Italy.
Insights
Hepatitis C virus (HCV) infection is prevalent in chronic hemodialysis patients. Cross-contamination in dialysis units, not blood transfusions, is the primary transmission route, with low intrafamilial spread.
Area of Science:
- Hepatology
- Infectious Diseases
- Epidemiology
Background:
- Hepatitis C virus (HCV) poses a significant risk to chronic hemodialysis patients.
- Understanding HCV epidemiology in this vulnerable population is crucial for effective prevention strategies.
Purpose of the Study:
- To investigate the epidemiology of HCV infection among chronic hemodialysis patients.
- To identify the primary transmission routes of HCV within this cohort and their families.
Main Methods:
- A multicenter study evaluated 387 chronic hemodialysis patients.
- Retrospective analysis compared ALT values and blood transfusions in seropositive patients.
- Intrafamilial transmission was assessed in 104 family members.
Main Results:
- The prevalence of HCV infection was 15.7% in hemodialysis patients.
- Acute hepatitis incidence was frequent; chronic hepatitis incidence was 17.5%.
- Intrafamilial diffusion was low (1.9%), suggesting negligible blood-transfusion-related infections and significant cross-contamination in dialysis units.
Conclusions:
- Cross-contamination within dialysis units is a critical factor in HCV transmission among hemodialysis patients.
- Blood transfusions appear to be a minor source of infection.
- Low intrafamilial spread indicates limited person-to-person transmission outside healthcare settings.
Abstract:
Three hundred and eighty-seven chronic hemodialysis patients were evaluated, in a multicenter study, to investigate the epidemiology of hepatitis C virus. In anti-HCV seropositive patients, serum ALT values and blood transfusions were retrospectively compared; blood donors were studied for serum transaminases. In seropositive patients without previous blood transfusions, analysis of dialysis schedule was done. Eventually, the intrafamilial transmission of hepatitis C virus was studied in 104 family members. The prevalence of HCV infection in hemodialysis patients was 15.7%. The incidence of acute hepatitis was frequent, while chronic hepatitis incidence was less than expected (17.5%). Intrafamilial diffusion was low (1.9%). Blood-transfusion-related infections seem to be negligible, while cross-contamination in dialysis units seems to be very important.