77 Comparison of Hepatitis C Seroconversion in Two Centers and Reuse Practices

COMPARISON OF HEPATITIS C SEROCONVERSION IN TWO CENTERS AND REUSE PRACTICES Maria de Jesus, Vivek Soi, Sancar Eke, Yahya Osman Malik, Jerry Yee, Roque Diaz. Henry Ford Hospital, Detroit, Michigan, USA. Several mechanisms could potentially contribute to nosocomial HCV transmission between hemodialysis patients. These include internal contamination of hemodialysis machines, contamination of the hands of staff members, item sharing and dialyzer reuse. The relationship between dialyzer reuse and anti-HCV positivity has been confirmed in some but not all studies. The purpose of this retrospective study was to compare the incidence of Hepatitis C seroconversion in two urban centers which differed with respect to dialyzer reuse. The incidence of Hepatitis C seroconversion was calculated for the two urban centers. Data between 2001 and 2006 from 339 patients from Center A and 356 from Center B was analyzed. During this time, dialyzer reuse occurred at Center B but did not occur at Center A. Because seroconversion was expected to occur at very low rates, a Poisson regression model was used to compare rates between centers as well as to estimate the relative risk of developing a seroconversion . Association between Dialyser Reuse (Center) and Seroconversion Rate Center Incidence Relative Risk (95% CI) P-value Center B (Reuse) 0.011 5.52 (1.93, 15.78) 0.002 Center A 0.062 The incidence of seroconversion was higher at Center A (0.062) where hemodialyzers were not reused than at Center B (0.011) where hemodialyzers were reused. The ratio of incidence of seroconversion for Center A relative to Center B was 5.52. There was between a 1.93 and 15.78 greater probability of seroconversion if a patient had hemodialysis at a center that did not reuse hemodialyzers relative to a center that did participate in reuse.This study illustrates that a non-reuse strategy does not significantly lower the risk of seroconversion when compared to the alternative. Other variables including the number of surgeries, transfusion load, race, and sex, were not significant predictors of seroconversion in the Poisson regression model. Intensification of other infection control procedures should be emphasized to prevent the spread of the Hepatitis C virus.