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Intrafamilial transmission of hepatitis C virus in hemodialysis patients
1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
Insights
Hepatitis C virus (HCV) infection is common in hemodialysis patients. However, their family members show no increased risk of HCV infection compared to the general population, with spouses having the highest risk.
Area of Science:
- Virology
- Epidemiology
- Nephrology
Background:
- Chronic hemodialysis patients exhibit high hepatitis C virus (HCV) prevalence (20-50%).
- These patients may act as a reservoir for HCV transmission to household contacts.
Purpose of the Study:
- To determine the prevalence of anti-HCV antibodies in hemodialysis patients and their families.
- To identify potential routes of HCV infection within family units.
Main Methods:
- Serum samples were collected from 84 hemodialysis patients and 186 family members.
- Anti-HCV testing was performed, and risk factors were assessed via questionnaires and interviews.
- A control group of 529 healthy adults was included for comparison.
Main Results:
- HCV prevalence was 44% in hemodialysis patients and 5.4% in family members, not significantly different from healthy adults.
- Spouses of infected hemodialysis patients showed a higher HCV risk (15%) compared to other family members (2.6%).
- Age was a significant factor, but other common risk factors (transfusions, surgery, injections) were not associated with HCV infection in family members.
Conclusions:
- Despite high HCV positivity in hemodialysis patients, their family members do not face a significantly elevated risk compared to the general population.
- Spouses of hemodialysis patients with HCV infection represent a high-risk group within the family unit.
- HCV transmission routes in families, beyond age, remain unclear and warrant further investigation.
Abstract:
The prevalence of hepatitis C virus (HCV) infection in chronic hemodialysis patients ranges from 20 to 50% and these patients may serve as a reservoir of infection for their household contacts. The aim of this study was to investigate the prevalence of anti-HCV in hemodialysis patients and their families, and to evaluate possible routes of infection. One hundred eighty-six family members of 84 hemodialysis patients and 529 healthy adults were enrolled. The family members consisted of 50 spouses, 96 children, 11 parents, 29 siblings, and other relatives living together with the patients. Serum samples were collected for testing anti-HCV. Exposure to risk factors was obtained by a questionnaire and an interview. The results showed that prevalence of anti-HCV in hemodialysis patients was 44%, whereas in family members it was 5.4%, not significantly different from that of age-matched healthy adults (standardized morbidity rate = 1.51, P = 0.390). The anti-HCV rate in family members tended to increase with age, and a spouse of an infected hemodialysis patient had a higher risk of HCV infection than other family members (15% vs. 2.6%, odds ratio 6.6, P = 0.058). Except for the age factor, no difference was found between seropositive and seronegative family members with respect to risk factors such as blood transfusion, surgery, frequent injections, dental procedures, or acupuncture. It was concluded that, although the anti-HCV positivity of hemodialysis patients is high, the risk of HCV infection for their family members is not higher than that of the general population. Among family members, spouses of seropositive hemodialysis patients have the highest risk of HCV infection.(ABSTRACT TRUNCATED AT 250 WORDS)