Abstract

We aimed to delineate the incidence of hepatitis C virus (HCV) infection and HCV seroconversion (SC) in maintenance hemodialysis (HD) patients and to evaluate the effect of isolation measures on HCV in HD unit. From June 1998 to June 2010, 2465 maintenance HD patients in our HD unit were enrolled in, and the anti-HCV ELISA and HCV nucleic acid testing were consecutively performed every six months. The results showed the prevalence rates of HCV antibody detected consecutively every six months were 54.7, 53.8, 52.6, 53.0 , 51.2, 45.9, 45.5 and 48.2% before 2002 (without isolation measures) and 35.6, 33.7, 33.7, 31.7, 30.4, 28.4, 27.2, 24.5, 20.8, 19.4, 16.6, 14.4, 15.3, 15.2, 12.5, 11.9 and 10.0% since 2002 (with isolation measures), respectively. HCV SC occurred in 238 patients during the follow-up period. 1077 patients were followed for 1 to 12 months, of which 49 (4.5%) had SC for HCV. The SC rate increased to 75% in 8 patients followed for 139 to 150 months. Taken together, we conclude that the dialysis environment is responsible for transmission of HCV either due to common usage of the machines or to the fact that the HCV positive patients are not isolated. The application of isolated hemodialysis of anti-HCV positive patients plus strict supervised universal infection control techniques significantly effect on the long-term prevalence of HCV antibody and SC in HD patients.

Key words: Hemodialysis, hepatitis C virus, seroconversion, blood transfusion, nosocomial transmission.