THE PREVALENCE OF ANTI‐HCV POSITIVITY IN PATIENTS UNDERGOING HAEMODIALYSIS OR WITH MALIGNANT DISEASE
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We studied the occurrence of anti-hepatitis C (HCV) antibodies in patients with malignant disease (53), in patients undergoing haemodialysis (56), and in blood donors (204) as healthy population controls. The study was carried out using the second-generation EIA test. Anti-HCV positivity was 23.2% in haemodialysis (HD) patients, 0.5% in blood donors, and 0% of the patients with malignant disease (MD). There was no association between anti-HCV positivity and the results of AST, ALT and HBsAg tests in patients and controls. But there was significant association of blood transfusion frequency and duration of HD with anti-HCV positivity in patients undergoing HD, and conversely an absence of this association in patients with MD. However, two of the anti-HCV-positive HD patients did not have any blood transfusion history. One HCV-positive blood donor had a history of surgical operation. Nosocomial transmission of HCV infection has replaced blood transfusion as the main risk factor in HD patients, and preventive measures should be performed in this direction to control infection.Keywords:
Hepatitis C
Due to frequent parenteral contact with blood transfusions hemodialysis patients are prone to acquire hepatitis C virus (HCV) infection. To determine the role of HCV infection we investigated the prevalence of antibodies to HCV in 188 hemodialysis patients. The prevalence of antibodies to HCV was 7.4%. As compared to anti-HCV-negative patients, anti-HCV-positive patients had slightly elevated transaminases which were independent of the presence of markers for hepatitis B virus infection. We conclude that HCV infection is common among dialysis patients.
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An enzyme immunoassay was used to detect antibodies to hepatitis C virus (anti-HCV) in 261 patients and 69 staff members of a hemodialysis unit. The prevalence of anti-HCV was 46.7% in patients and 2.9% in staff members (p < 0.001). The prevalence of anti-HCV increased significantly with increasing duration of hemodialysis (p < 0.001), but was not related to age, sex, history of blood transfusion, status of hepatitis B or hepatitis A virus infection, or serum ALT. Patients with hepatitis episode increased with increasing duration of hemodialysis and showed a significantly higher prevalence of anti-HCV than those without (63.1 vs. 34.7%, p < 0.001). The prevalence of anti-HCV in patients with hepatitis also increased with increasing duration of hemodialysis (p = 0.05). Thus, HCV appears to be the major cause of hepatitis in hemodialysis patients. Besides strict infection control measures, further studies are needed to determine the mode of HCV infection and its prevention in the hemodialysis unit.
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Objective To investigate the hepatitis C virus (HCV) infection in patients with maintained hemodialysis for 6 years in the hemodialysis center of Beijing Friendship Hospital, and to analyse the risk factor of HCV infection. Methods HCV RNA , the serum virus antibody were detected in hemodialysis patients . The relationship between the infection of hepatitis virus and the dialysis time, blood infusion and hepatic function was analysed. Results The percentage of HCV infection patients was 10.3% ,8.8%, and 7.3% in 2004,2009,2010 respectively. 111 patients were treated in our center for more than 6 years. There was no new HCV infection in these group patients during 6 years. Blood infusion and the history of kidney implantation were the risk factors. Conclusion The percentage of HCV infection in hemodialysis patients was reduced in our dialysis center. Avoidance blood transfusion and infection control of blood purification standard operating procedure are the major ways to prevent transmit HCV in patient with MHD.
Key words:
Hepatitis C virus; Hemodialysis; Blood transfusion; Standard operating procedure
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Objectives Analyzed the association between hepatitis C virus (HCV) infection and clinical outcome in maintenance hemodialysis. Methods Retrospective study of 106 patients died after initiation dialysis one year. They were divided into Anti-HCV+ and Anti-HCV-. Results Anti-HCV+ were significant higher liver enzymes, lower serum albumin and dialysis vintage. Cardiovascular mortality was the common cause of death in both groups.Conclusions Maintenance hemodialysis patients infected hepatitis C virus had poor outcome.
Key words:
Hepatitis C-Like Viruses; Hemodialysis; Prognosis
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Abstract Background Sexual transmission of hepatitis C virus (HCV) is still debated. The aim of this study was to evaluate the role of sexual transmission of HCV among hemodialysis patients and their partners. Methods We investigated intrafamilial spread of HCV between 53 married hemodialysis patients reporting stable monogamous sexual activity and their partners, using an epidemiological questionnaire on risk factors for HCV, a third‐generation ELISA to determine anti‐HCV status, and a PCR test to detect HCV RNA. An additional 84 single patients with no reported regular sexual activity were considered the control group. Results Of the 53 married patients, 16 (30.2%) were anti‐HCV positive (all HCV‐RNA positive), and 37 were anti‐HCV negative (all HCV‐RNA negative). There were no statistically significant differences between anti‐HCV‐positive and anti‐HCV‐negative married patients in mean age, gender, blood transfusion, and mean time on dialysis. None of the husbands or wives of the 16 anti‐HCV‐positive hemodialysis patients had antibodies to HCV. Similarly, of the 37 partners of anti‐HCV‐negative patients, none was anti‐HCV positive. Conclusion Our data suggest a very low risk of heterosexual transmission of HCV between hemodialysis patients and their partners.
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For four decades, hepatitis often strikes hemodialysis (HD) patients. The seroprevalence of hepatitis infection in HD ranges from country to country. The study design of two parts, the first partisan estimate of the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in Baghdad teaching hospital/departmentof HD, and the second part is an association between HBV, and HCV transmission and other suspected risk factors dental office and tattooing. A one hundred patients who underwent serum anti-HBC and anti-HCV examination at Baghdad teaching hospital/department of dialysis were enrolled in the study. The chemiluminescence assay has been used to test HBV and HCV antibodies, and an automated kinetic method was used for liver function tests. HCVAb was detected in thirty-five (35%) dialysis patients, and the total HBcAb and infection HBsAg were detected in five (5%) and zero (0%) respectively. No Co-infection was observed. Seroprevalence results related to transfusion requirement was 4 (7.4%) for total HBcAb, zero (0%) for HBsAg, and 32 (59.3%) for HCVAb. There was no significant difference between blood transfusion and non-transfusion in risk prevalence of total HBcAb and HBsAg, but the risk of HCV infection was significantly higher in the blood transfusion (p < 0.001). In the logit model analysis, the main risk factor for HCV infection in the entire sample was blood transfusion (OR = 20.8, 95% CI: 5.7-75.7, p < 0.001). The association between HCV transmission and risk behavior among patients that contribute its spread in society such as dental healthcare (DHC) (OR = 0.98, 95% CI: 0.925-1.615, p < 0.05) and tattoos (OR = 0.75, 95% CI: 0.503-1.119). A non-significant increase in alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin, while, non-significant decrease in albumin in HCV-positive hemodialysis patients compared with HCV-negative dialysis patients. Our findings indicate a high incidence of HCV virus infection in patients who received blood. However, no transmitting risk appeared from such patients when using dental tools or tattoos tools.
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To investigate whether nosocomial infection with hepatitis C virus (HCV) in chronic hemodialysis patients is related primarily to hemodialysis procedures, a multicenter analysis was carried out on 2,132 chronic hemodialysis patients (male: 1,274, female: 858) from 23 dialysis units using a second-generation anti-HCV antibody assay. The prevalence of anti-HCV antibodies in patients with blood transfusion (29.9%) was significantly higher (P < .0001) than in those without blood transfusion (7.6%). Although the prevalence of anti-HCV antibodies increased with the length of hemodialysis in males without blood transfusion, it did not increase even after long-term hemodialysis (more than 5 years) in females without blood transfusion, who exhibited a rate (1.9%) similar to that of healthy blood donors in Japan. There was a significant correlation between the presence of anti-HCV antibodies and anti-HBs antibody in males without blood transfusion. In anti-HBs antibody-negative male patients without blood transfusion, the prevalence of anti-HCV antibodies was significantly lower compared with anti-HBs antibody-positive male patients without blood transfusion. There was marked difference in the prevalence rate in patients without blood transfusion among dialysis units, and there was no correlation between the prevalence and the mean period of dialysis of each dialysis unit. Although nosocomial infection with HCV appears to be related to the hemodialysis environment, the low prevalence of anti-HCV antibodies in females suggests that dialysis procedures per se may not present the risk of hepatitis C virus infection. © 1996 Wiley-Liss, Inc.
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We determined the prevalence and incidence of hepatitis C virus (HCV) infection among hemodialysis patients and evaluate their risk factors. 80 patients on maintenance hemodialysis in Peking Union Medical College Hospital Dialysis Center from December 1994 to June 1995 were studied. 30 medical students were used as health controls. Serum samples were tested for HCV antibodies by a second-generation enzyme-linked immunosorbent assay (ELISA) and for HCV RNA using nested polymerase chain reaction (PCR) and retested for anti-HCV and HCV RNA three months later. 24 (30%) of 80 hemodialysis patients were anti-HCV positive, and 2 (3.6%) of 56 anti-HCV negative cases were found HCV RNA positive. By combined assessment, the HCV infection rate of hemodialysis patient was 32.5% (26/80). Mantel-Haenszel analysis showed that HCV infection was associated with multi-transfusions, dialysis over a long period, renal transplantation, history of operation. Samples of dialysate in 9 serum HCV RNA positive cases were directly detected for HCV RNA, and 3 were found HCV RNA detectable. HCV infection rate in hemodialysis patients is higher than that of general population. The main risk factors for HCV transmission is transfusion of unscreened blood but is not an independent factor, hemodialysis itself plays an important role, the length of time on dialysis, renal transplantation, blood-contaminated material and contaminated dialysis equipment are also the risk factors. Infected hemodialysis patients should be isolated.
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