Comparative Study of HCV Seroconversion among Patients under Hemodialysis Regarding Isolation Policy

Abstract

Infection with HCV is worldwide significant problem in public health.Hepatitis C virus (HCV) is important causes of liver diseases, including cirrhosis and hepatocellular carcinoma. Since HCV is efficiently transmitted by parenteral route, patients undergoing hemodialysis are at high risk of acquiring these blood borne hepatitis agents. A variety of epidemiological data provides evidence for the occurrence of nosocomial transmission of hepatitis C virus (HCV) infection to hemodialysis (HD) patients. In order to limit spread of this blood borne hepatitis agent in hemodialysis units several investigators reported that strict implementation of universal precautions is sufficient .Also; other prospective observational studies have reported a reduction of HCV transmission after the reinforcement of basic hygienic precautions, without any isolation measures. On theother hand some authors have focused on isolation of HCV positive patients and have shown that nosocomial transmission of HCV decreased after isolation of HCV-positive patients. The aim of our work was to retrospectively determine the incidence of HCV seroconversion among patients undergoing hemodialysis in two units adopting different isolation policies, both of which follows the same standard precautions and verifying the role of such isolation and other risk factors in virus seroconversion if any, within a one year follow up. The patients were divided into two groups: - Group A: 50 Patients under hemodialysis in the isolation policy adopting unite for HCV infected patients (Ain Shams University hospital). - Group B: 50 Patients under hemodialysis in the unite not abide by isolation policy (Al-Moez Bellah Hospital). After one year of HD, all patients were HCV Ab negative by ELISA 3. While HCV RNA was detected in 16% of group B patients, but none of Group A patients had detectable HCV RNA. A result showing a highly significant incidence of HCV seroconversion (P-value = 0.001). Strikingly, most seroconversion risk factors were significantly higher in Group A rather than Group B, yet seroconversion was among Group B population indicating the beneficial value of isolating HCV infected patients.