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Risk factors for HCV infection in two haemodialysis units in The Netherlands
I Keur1, P M Schneeberger, Y van der Graaf
1Diatel Haemodialysis Centre, Amsterdam, Netherlands.
Background:
In order to assess risk factors for HCV infection during haemodialysis, all patients receiving haemodialysis for more than 6 months in two separate units in the Netherlands were studied retrospectively.
Methods:
Antibodies to HCV, HCV-RNA and HCV genotypes were determined. Risk factors were identified by analysis of an extensive collection of clinical data.
Results:
In unit A, 8 out of 75 (11%) patients and in unit B 4 out of 122 (3%) patients had antibodies to HCV. Eleven out of the 12 anti-HCV-positive patients had detectable HCV-RNA. Genotyping showed the presence of 4 different genotypes in unit A (1, 1a, 2b, and 3a). Three patients in unit B were infected with the same genotype (1b), where one of these patients was also infected with genotype 1a. One patient in unit B did not have detectable HCV-RNA. The risk of acquiring a HCV infection in unit A was associated with the number of blood transfusions. However, in unit B this risk was associated with the duration of dialysis. Other factors such as the number of surgical procedures were not associated with HCV infection.
Conclusions:
Blood transfusions and the dialysis process itself are important and independent risk factors for HCV transmission in dialysis patients. Surgical events do not appear to be important risk factors. However, relative risks may vary considerably between different dialysis centres.