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High Prevalence of Hepatitis C Infection Among Patients Receiving Hemodialysis at an Urban Dialysis Center

Published online by Cambridge University Press:  02 January 2015

Sumathi Sivapalasingam ,
Sharp F. Malak ,
John F. Sullivan ,
Jonathan Lorch  and
Kent A. Sepkowitz
Sumathi Sivapalasingam
Affiliation:
Department of Medicine, New York Presbyterian Hospital, Cornell Campus, New York, New York
Sharp F. Malak
Affiliation:
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
John F. Sullivan
Affiliation:
Department of Medicine, New York Presbyterian Hospital, Cornell Campus, New York, New York
Jonathan Lorch
Affiliation:
Department of Medicine, New York Presbyterian Hospital, Cornell Campus, New York, New York
Kent A. Sepkowitz*
Affiliation:
Department of Medicine, New York Presbyterian Hospital, Cornell Campus, New York, New York Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
*
Clinical Infectious Disease Section, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Box 288, New York, NY 10021
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Abstract

Objective:

To determine the seroprevalence and risk factors for hepatitis C virus (HCV) infection among patients at an urban outpatient hemodialysis center.

Methods:

This was a cross-sectional study of 227 patients undergoing hemodialysis at the Rogosin Kidney Center on December 15, 1998, with a response rate of 90% (227 of 253). Laboratory records were used to retrieve the total number of blood transfusions received and serologic study results. Univariate and multivariate analyses were used to examine the relationship among HCV serostatus, patient demographics, and HCV risk factors (eg, intravenous drug use [IVDU], intranasal cocaine use, multiple sexual partners, comorbidities, length of time receiving hemodialysis, and total number of blood transfusions received).

Results:

The seroprevalence of antibody to HCV (anti-HCV) was 23.3% (53 of 227) in the population. In univariate analysis, factors associated with HCV seropositivity included male gender, younger age, history of IVDU, history of intranasal cocaine use, history of multiple sexual partners, human immunodeficiency virus coinfection, increased time receiving dialysis, history of renal transplant, and positive antibody to hepatitis B core antigen. Multivariate logistic regression analysis showed that longer duration receiving dialysis and a history of IVDU were the only risk factors that remained independently associated with HCV seropositivity.

Conclusions:

HCV is markedly more common in our urban cohort of patients receiving hemodialysis compared with patients receiving dialysis nationally and is associated with a longer duration of receiving dialysis and a history of IVDU. Stricter and more frequent enforcement of universal precautions may be required in hemodialysis centers located in areas with a high prevalence of HCV infection or IVDU among the general population.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 6 , June 2002 , pp. 319 - 324
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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References

1.Alter, MJ, Margolis, HS, Krawczynski, K, et al. The natural history of community-acquired hepatitis C in the United States. N Engl J Med 1992; 32:1899–1905.Google Scholar
2.Alter, MJ, Kruszon-Moran, D, Nainan, OV, et al. The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med 1999;341:556–562.Google Scholar
3.Tokars, JI, Miller, ER, Alter, MJ, Arduino, MJ. National Surveillance of Dialysis-Associated Diseases in the United States, 1997. Atlanta, GA: Centers for Disease Control and Prevention; 1997.Google Scholar
4.Stehman-Breen, CO, Emerson, S, Gretch, D, Johnson, RJ. Risk of death among chronic dialysis patients infected with hepatitis C virus. Am J Kidney Dis 1998,32:629–634.Google Scholar
5.Mathurin, P, Mouquet, C, Poyard, T, et al. Impact of hepatitis B and C virus on kidney transplantation outcome. Hepatology 1999;29:257–263.Google Scholar
6.Pujol, FH, Ponce, JG, Lema, MG, et al. High incidence of hepatitis C infection in hemodialysis patients in units with high prevalence. J Clin Microbiol 1996;34:1633–1636.Google Scholar
7.Hayashi, J, Nakashima, K, Kajiyama, W, et al. Prevalence of antibody to hepatitis C virus in hemodialysis patients. Am J Epidemiol 1991;134:651–657.Google Scholar
8.Niu, MT, Coleman, PJ, Alter, MJ. Multicenter study of hepatitis C virus infection in chronic hemodialysis patients and hemodialysis center staff members. Am J Kidney Dis 1993;22:568–573.Google Scholar
9.Jeffers, LJ, Perez, GO, de Medina, MD, et al. Hepatitis C infection in two urban hemodialysis units. Kidney Int 1990;38:320–322.Google Scholar
10.dos Santos, JP, Loureiro, A, Cendoroglo, M, Pereira, BJG. Impact of dialysis room and reuse strategies on the incidence of hepatitis C virus infection in hemodialysis units. Nephrol Dial Transplant 1996;11:2017–2022.Google Scholar
11.Hardy, NM, Sandroni, S, Danielson, S, Wilson, WJ. Antibody to hepatitis C virus increases with time on hemodialysis. Clin Nephrol 1992;38:44–48.Google Scholar
12.Brugnano, R, Francisci, D, Quintaliani, G, et al. Antibodies against hepatitis C virus in hemodialysis patients in the central Italian region of Umbria: evaluation of some risk factors. Nephron 1992;61:263–265.Google Scholar
13.Zeldis, JB, Depner, TA, Kuramoto, IK, Gish, RG, Holland, PV. The prevalence of hepatitis C virus antibodies among hemodialysis patients. Ann Intern Med 1990;112:958–960.Google Scholar
14.Forseter, G, Wormser, GP, Adler, S, Lebovics, E, Calmann, M, O'Brien, TA. Hepatitis C in the health care setting: II. Seroprevalence among hemodialysis staff and patients in suburban New York City. Am J Infect Control 1993;21:5–8.CrossRefGoogle ScholarPubMed
15.Mitwalli, A, al-Mohaya, S, al-Wakeel, J, et al. Hepatitis C in chronic renal failure patients. Am J Nephrol 1992;12:288–291.Google Scholar
16.Olmer, M, Bouchoareb, D, Zandotti, C, de Micco, P, de Lamballerie, X. Transmission of the hepatitis C virus in an hemodialysis unit: evidence for nosocomial infection. Clin Nephrol 1997;47:263–270.Google Scholar
17.Petrosillo, N, Gilli, P, Serraino, D, et al. Prevalence of infected patients and understaffing have a role in hepatitis C virus transmission in dialysis. Am J Kidney Dis 2001;37:1004–1010.Google Scholar
18.Seme, K, Poljak, M, Zuzek-Resek, S, Debeljak, M, Dove, P, Koren, S. Molecular evidence for nosocomial spread of two different hepatitis C virus strains in one hemodialysis unit. Nephron 1997;77:273–278.Google Scholar
19.Izopet, J, Pasquier, C, Sandres, K, Puel, J, Rostaing, L. Molecular evidence for nosocomial transmission of hepatitis C virus in a French hemodialysis unit. J Med Virol 1999;58:139–144.Google Scholar
20.Alter, MJ. Hepatitis C infection in the United States. J Hepatol 1999:31(suppl 1):88–91.Google Scholar
21.Conry-Cantilena, C, Van Raden, M, Gibble, J, et al. Routes of infection, viremia, and liver disease in blood donors found to have hepatitis C virus infection. N Engl J Med 1996;334:1691–1696.Google Scholar
22.Pereira, BJ, Milford, EL, Kirkman, RL, Levey, AS. Transmission of hepatitis C virus by organ transplantation. N Engl J Med 1991;325:454–460.Google Scholar
23.Pereira, BJG, Milford, EL, Kirkman, RL, et al. Prevalence of hepatitis C virus RNA in organ donors positive for hepatitis C antibody and in the recipients of their organs. N Engl J Med 1992;327:910–915.Google Scholar
24.Jadoul, M, Cornu, C, Van Ypersele De Strihou, C. Universal precautions prevent hepatitis C virus transmission: a 54 month follow-up of the Belgian Multicenter Study. Kidney Int 1998;53:1022–1025.Google Scholar