Hepatitis C virus seroconversion and genotype prevalence in patients and staff on chronic hemodialysis

The prevalence of hepatitis C virus (HCV)-RNA positivity among hemodialysis patients varies between 10 and 70%. Few previous surveys revealed high fre quency of seroconversion of HCV-RNA-negative patients over the years of hem odialysis. Only few studies reported HCV genotype variability. We evaluated all 65 patients on chronic hemodialysis in our dialysis unit. All sera pos itive to anti-HCV on ELISA were retested by reverse transcriptase polymeras e chain reaction to HCV-RNA. Sixteen patients were found anti-HCV positive on ELISA, and 8 of them were also PCR positive. Three of these eight patien ts seroconverted during the year 1995. Four patients had both la and Ib gen otypes of HCV, coexistence of genotypes Ib and 4a in one patient and genoty pes la, Ib and 2a in the remaining three patients. Mean serum aminotransfer ase, duration of dialysis, and number of blood units transfused were signif icantly higher in the HCV-PCR-positive patients compared with the HCV-PCR-n egative patients. Because strict isolation methods were initiated at the en d of 1995, not one new case of HCV among dialysis patients was found in 199 8, although new hemodialysis patients were diagnosed as having HCV. In conc lusion, genotypes la and Ib, as is true for the general population in Israe l, were also the predominant genotypes among hemodialysis patients; the coe xistence of more than one genotype is common among hemodialysis patients; s eroconversion is common among these patients and strict isolation methods a re efficient and should be recommended.