INCIDENCE AND RISK-FACTORS OF HEPATITIS-C VIRUS-INFECTION IN A HEMODIALYSIS UNIT

Background. Hepatitis viruses have become one of the main infectious p roblems in patients on maintenance haemodialysis. The aim of this stud y was to prospectively investigate the incidence of de novo hepatitis C virus (HCV) infection in a haemodialysis unit and to identify factor s currently involved in HCV transmission to haemodialysis patients. Me thods. One hundred and fourteen anti-HCV negative and HCV-RNA negative patients who started long-term haemodialysis were followed for a mean period of 36 months (range 18-56). Liver tests and anti-HCV were perf ormed at 6-month intervals. Factors that might be implicated in HCV tr ansmission, such as blood transfusions, sexual habits, surgery and oth er invasive procedures, were recorded. HCV markers were re-examined in transfused blood and the HCV genotype was investigated in seroconvert ers to anti-HCV and in patients with previous HCV infection who were t reated iu the vicinity of those who seroconverted. Results. Eight pati ents (7%) seroconverted to anti-HCV and seven of them became HCV-RNA p ositive. HCV markers, including HCV-RNA, were negative in the blood tr ansfused to seroconverters. No differences between seroconverters and non-seroconverters were found in other risk factors not directly relat ed to haemodialysis. The investigation of HCV genotype suggested that HCV transmission was not restricted to patients treated in the vicinit y of previously HCV infected patients. Occasional failure to observe s trict measures of asepsis was detected in the haemodialysis unit and t his was the only factor that might be incriminating. Conclusions, HCV acquisition in patients on haemodialysis is currently not related to b lood transfusion, and nosocomial transmission within the haemodialysis unit seems to be the main mechanism of HCV infection.