PREVENTION OF HEPATITIS-C VIRUS IN DIALYSIS UNITS

To understand how to prevent the diffusion of hepatitis C virus (HCV) in dialysis units, 289 chronic dialysis patients treated in a renal de partment from the beginning of 1990 to June 30, 1993, were studied. Pa tients were screened monthly for alanine aminotransferase values and e very 3 months for anti-HCV antibodies. At the beginning of the study t he prevalence of anti-HCV antibodies was 24.7%. Two study groups were defined. In the first, anti-HCV-positive patients were treated on sepa rate machines; in the second, 13 anti-HCV-positive and 13 negative pat ients shared the same machines. Patients in the study were treated wit h traditional dialysis, employing low-permeability membranes and dispo sable dialysate circuits on machines without an ultrafiltration contro l device. The 'universal precautions' were rigorously applied. The use of blood transfusions was markedly reduced. Although new patients sta rting dialysis treatment revealed a high frequency of HCV positivity ( 10.8%), the overall prevalence of HCV infection in the department did not increase during the follow-up period. Furthermore, no seroconversi on was found in patients on dialysis treatment, not only in the sectio n where anti-HCV-positive patients were treated on separate machines, but also in the section where anti-HCV-positive and anti-HCV-negative patients shared the same machines. The possibility of an intradialytic diffusion of HCV appeared to be very low and the treatment of infecte d patients on separate machines not strictly necessary.