Systematic monitor disinfection is effective in limiting HCV spread in hemodialysis

Background: Patients on chronic hemodialysis are at high risk of HCV infect ion due to nosocomial transmission. The strict adhesion to universal precau tions is the first step in prevention, but other simple tools such as syste matic monitor disinfection and the use of separate machines for anti-HCV-po sitive patients need to be evaluated. Methods: A 5-year prospective study w as carried out in 4 dialysis centers enrolling 135 patients. General precau tions were adopted, but anti-HCV-positive patients were not isolated. In pe riod A, lasting 24 months, monitor disinfection was performed after each di alysis session with sodium hypochlorite; peracetic acid was also used 3 tim es a week. In period B, lasting 36 months, 3 dialysis units (77 patients) p rolonged the same preventive protocol of period A, while another unit (58 p atients) also adopted the use of separate machines for anti-HCV-positive su bjects. A third-generation ELISA anti-HCV test was performed every 2 months throughout the study. Results: Anti-HCV antibodies were initially detected in 43 patients (31.8%), prevalence rate ranging from 25 to 39.4%. One sero conversion occurred in period A, with an overall seroconversion rate of 0.5 4%/year. Also in period B one seroconversion occurred (unit 2), seroconvers ion rate of 0.36%/year. Therefore the mean seroconversion rate throughout t he 5 years was 0.43%/year. Conclusion: Systematic monitor disinfection may be a simple and quite effective tool to avoid nosocomial transmission of HC V infection in the hemodialysis setting. In our opinion its use is mandator y. The use of separate machines for anti-HCV-positive patients seems unnece ssary. Copyright (C) 2000 S. Karger AG, Basel.