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Article Type

Original Study

Abstract

Objective The objective of this study was to determine whether the isolation of hemodialysis patients with hepatitis C virus (HCV) in hemodialysis units with a high prevalence of hepatitis C is necessary or not. Background HCV is one of the most common pathogens leading to serious morbidity and mortality in hemodialysis patients. Despite the quality control measures developed to reduce the risk of HCV transmission, HCV persists, and nosocomial virus transmission remains a concern. Patients and methods This study included 514 patients with end-stage renal disease on regular hemodialysis in Menoufia governorate, Egypt. Of them, 303 patients started dialysis with negative HCV, and 44 patients seroconverted to HCV positive during dialysis. Patients were divided into two groups: group 1, which included 259 patients who remained negative for HCV, and group 2, which included 44 patients who seroconverted to HCV positive during dialysis. Risk factors for seroconversion were compared between the two groups. Results The duration of dialysis in months (33.72 in group 1 compared with 71.36 in group 2), a positive family history for HCV infection (6.4% in group 1 vs. 20.5% in group 2), and a low socioeconomic level (58.3% in group 1 vs. 72.7% in group 2) were found to be significant among the studied groups. Other factors such as blood transfusion, surgery, dentist visit, a history of bilharziasis and hepatitis B virus vaccination were found to be insignificant. The duration of dialysis was found to be a key predictor of HCV seroconversion Conclusion Patients with a long duration of dialysis were more liable to HCV seroconversion in dialysis units with a high prevalence rate of HCV infection, especially in developing countries. Good training on infection control measures with strict supervision of the dialysis staff is required. A controlled randomized study is needed to compare the isolation policy with no isolation of HCV patients on regular hemodialysis in developing countries to determine whether there is any benefit of isolation.

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