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HIV infection in a high prevalence hemodialysis unit

K Chirgwin1, T K Rao, S H Landesman

  • 1Department of Medicine, State University of New York Health Science Center, Brooklyn.

AIDS (London, England)
|November 1, 1989
PubMed

Insights

Intravenous drug users (IVDUs) with end-stage renal disease show a high rate of Human Immunodeficiency Virus (HIV) infection. Even in high-prevalence hemodialysis units, the risk of HIV transmission to staff and uninfected patients is low.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Epidemiology

Background:

  • A significant increase in end-stage renal disease (ESRD) among intravenous drug users (IVDUs) was observed between 1981 and 1987.
  • This rise occurred despite stable IVDU populations and unchanged referral patterns, suggesting an underlying factor linked to ESRD in this demographic.

Purpose of the Study:

  • To investigate the interrelationship between Human Immunodeficiency Virus (HIV) infection and the rising incidence of renal failure in IVDUs.
  • To assess the risk of nosocomial HIV transmission within a hemodialysis unit with a high prevalence of infection.
  • To evaluate the clinical impact of HIV seropositivity on patients undergoing maintenance hemodialysis.

Main Methods:

  • A survey of serology, clinical status, and risk factors for HIV infection was conducted in a maintenance hemodialysis unit.
  • Patients undergoing maintenance hemodialysis were prospectively evaluated for HIV status and clinical outcomes.
  • HIV testing was performed on dialysis patients and staff, with risk factor assessment.

Main Results:

  • Out of 70 maintenance hemodialysis patients, 27 (39%) were HIV-seropositive.
  • Among 26 IVDUs receiving dialysis, 23 (88%) were HIV-seropositive.
  • Despite low CD4 counts, only one HIV-positive patient developed AIDS during 12 months of follow-up. No staff or non-IVDU patients without risk factors tested positive for HIV.

Conclusions:

  • IVDUs developing end-stage renal disease exhibit a high prevalence of HIV infection.
  • The number of HIV-infected dialysis patients is expected to increase.
  • The risk of nosocomial HIV transmission in this hemodialysis setting appears minimal.

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