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Hepatitis C in hemodialysis patients: current global magnitude, natural history, diagnostic difficulties, and

Mohammad Rahnavardi1, Seyed Mohammadmehdi Hosseini Moghaddam, Seyed Moayed Alavian

  • 1Urology and Nephrology Research Center, Shaheed Labbafinejad Medical Center, Shahid Beheshti University, MC, Tehran, IR Iran.

American Journal of Nephrology
|February 21, 2008
PubMed

Insights

Hepatitis C virus (HCV) infection is a concern in hemodialysis (HD) patients, with prevalence varying globally. Strict universal precautions are recommended to prevent patient-to-patient transmission in HD units.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Virology

Background:

  • Hepatitis C virus (HCV) infection significantly impacts morbidity and mortality in hemodialysis (HD) patients.
  • Prevalence of HCV in HD populations varies widely globally, ranging from 1.9% to 84.6% in recent years.
  • While duration of HD and blood transfusions have been considered risk factors, recent evidence suggests other transmission routes.

Purpose of the Study:

  • To provide an updated review of the epidemiological and clinical features of HCV in the HD population.
  • To evaluate the accuracy of serologic testing for HCV detection in HD patients.
  • To assess the necessity of patient isolation and dedicated equipment for HCV control in HD units.

Main Methods:

  • Review of existing literature on HCV prevalence, risk factors, diagnostic accuracy, and transmission in hemodialysis patients.
  • Analysis of data regarding the false-negativity rate of serologic testing for HCV in HD patients.
  • Evaluation of phylogenetic analyses to understand HCV transmission patterns within HD units.

Main Results:

  • The false-negativity rate of serologic testing for HCV in HD patients is low, estimated at no more than 1.66%.
  • Phylogenetic analyses suggest patient-to-patient transmission of HCV within HD units, likely via contaminated hands and articles.
  • Current data do not justify isolation of HCV-infected patients or the use of dedicated HD machines.

Conclusions:

  • Routine virologic testing is not recommended to replace serologic testing for HCV diagnosis in HD patients due to acceptable accuracy.
  • Strict adherence to universal precautions is sufficient to control HCV spread in HD settings.
  • Isolation of HCV-infected patients and dedicated machines are currently not warranted.

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