Prevalence and Incidence of Hepatitis C Virus in Hemodialysis Patients in British Columbia: Follow-up after a Possible Breach in Hemodialysis Machines

BACKGROUND: A possible breach of the transducer protector in specific dialysis machines was reported in June 2004 in British Columbia (BC), which led to testing of hemodialysis patients for hepatitis C virus (HCV), hepatitis B virus (HBV) and HIV. This testing provided an opportunity to examine HCV incidence, prevalence and coinfection with HBV and HIV, and to compare anti-HCV and HCV polymerase chain reaction (PCR).METHODS: The results of hemodialysis patients who were dialyzed on the implicated machines (65% of BC dialysis patients), and tested for HCV, HBV and HIV, between June 1, 2004, and December 31, 2004, were reviewed and compared with available previous results.RESULTS: Of 1286 hemodialysis patients with anti-HCV and/or HCV-PCR testing, 69 (5.4%) tested positive. Two HCV genotype 4 seroconversions were identified. HCV incidence rate on dialysis was 78.8 cases per 100,000 person-years. Younger age, history of renal transplant and past HBV infection were associated with HCV infection. No occult infection was identified using HCV-PCR.INTERPRETATION: Hemodialysis patients had three times the HCV prevalence rate of the general BC population, and more than 20 times the incident rate of the general Canadian population. One of the two seroconversions occurred before the testing campaign; the patient was likely infected during hemodialysis in South Asia. The other was plausibly a late seroconversion following renal transplant in South Asia. Nosocomial transmission cannot be ruled out because both patients were dialyzed in the same centre. Baseline and annual anti-HCV testing is recommended. HCV-PCR should be considered at baseline for persons with HCV risk factors, and for returning travellers who received dialysis in HCV-endemic countries to identify HCV infection occurring outside the hemodialysis unit.

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Hepatitis C Virus Infection and Genotypes in Chronic Hemodialysis Patients in Kinshasa: Prevalence and Risk Factors

10.21203/rs.3.rs-191077/v1 ◽

2021 ◽

Author(s):

Mathieu Muna Ngilibuma ◽

Vieux Momeme Mokoli ◽

Yannick Mayamba Nlandu ◽

Yannick Mompango Engole ◽

Cedric Kabemba Ilunga ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Hcv Infection ◽

Sub Saharan Africa ◽

Steady Increase ◽

Genotype 4 ◽

Genotype 2

Abstract IntroductionThe steady increase in the number of chronic hemodialysis patients in sub-Saharan Africa (SSA) calls for improved management of those patients. The present study aimed to determine the frequency of hepatitis C virus (HCV) infection, the prevalent genotypes and the risk factors associated with HCV in hemodialysis patients in Kinshasa (DR Congo). MethodsA cross sectional study was conducted from February to June 2018 in all hemodialysis centers in Kinshasa. Blood samples were collected from 127 chronic hemodialysis patients and tested for the presence of antibodies against HCV. The HCV genotype was identified by real time polymerase chain reaction (RT- PCR). ResultsTwenty-two (17.3 %) patients were anti-HCV positive, ranging from 0 % to 52.9 % in different centers. Genotype 4 was detected in 18/22 (81.8 %), followed by genotype 2 in 2/22 (9.1%), and both genotypes 2 and 4 in one patient (4.5%). One patient had an undetermined genotype (4.5 %). Having received at least 4 transfusions [7,21 (1,09-10,61); p=0.040)], not being under EPO treatment [5,81(1,47-12,96); p=0.012)], being on hemodialysis for at least 14 months [3,63(1,60-5,05); p=0.035)]and being dialyzed in an overloaded center [2,06(0,83-5,86); p=0.073)] were associated with a greater risk of HCV infection.ConclusionThis study highlights the importance of strategies to prevent HCV infection in hemodialysis patients in Kinshasa. This issue is important for SSA countries which are facing several economic and logistical challenges.

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Hepatitis C virus infection in hemodialysis patients in Maracaibo, Venezuela

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652012000100010 ◽

2012 ◽

Vol 54 (1) ◽

pp. 53-55 ◽

Cited By ~ 2

Author(s):

Francisca Monsalve-Castillo ◽

Liliana Gómez-Gamboa ◽

Leonor Chacín-Bonilla ◽

Leticia Porto-Espinoza ◽

Luciana Costa-León

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Preventive Measures ◽

Hemodialysis Patients ◽

Hcv Infection ◽

University Hospital ◽

Fourth Generation ◽

Hepatitis C Virus Infection ◽

Hemodialysis Unit ◽

The University

Over a two year period, the incidence of hepatitis C virus (HCV) infection was evaluated in 29 hemodialysis patients, aged between 15 and 75 years (mean ± SD: 45 ± 39.5 years), from the University Hospital Hemodyalisis Unit, Maracaibo, Zulia State, Venezuela. Anti-HCV antibodies were determined using a fourth generation ELISA (Innotest HCV Ab IV) kit and positive blood samples were tested using a recombinant assay kit (Inno-LIA HCV Ab III), both kits from Innogenetics N.V., Belgium. The findings indicate a lack of HCV seroconversion in the hemodialysis patients over the study period, confirmed by the recombinant assay. Risk factors for HCV infection were 0.3270 (95% confidence interval: 0.01323-8.080) in patients undergoing hemodialysis. The findings suggest a lack of significant sources for HCV infection due to the preventive measures to avoid its transmission in the hemodialysis unit.

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Prospective study of hepatitis C virus infection in hemodialysis patients by monthly analysis of HCV RNA and antibodies

Canadian Journal of Microbiology ◽

10.1139/w03-065 ◽

2003 ◽

Vol 49 (8) ◽

pp. 503-507 ◽

Cited By ~ 25

Author(s):

Regina Moreira ◽

João Renato Rebello Pinho ◽

Jorge Fares ◽

Isabel Takano Oba ◽

Maria Regina Cardoso ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Hemodialysis Patients ◽

Hcv Infection ◽

Hcv Rna ◽

Hepatitis C Virus Infection ◽

Serum Samples ◽

Hcv Genotypes ◽

High Prevalence ◽

Time Required

The aims of this study were to (i) evaluate the prevalence and the incidence of hepatitis C virus (HCV) infection in hemodialysis patients in two different centers in São Paulo (Brazil), (ii) determine the time required to detect HCV infection among these patients by serology or PCR, (iii) establish the importance of alanine aminotransferase determination as a marker of HCV infection, and (iv) identify the HCV genotypes in this population. Serum samples were collected monthly for 1 year from 281 patients admitted to hospital for hemodialysis. Out of 281 patients, 41 patients (14.6%) were HCV positive; six patients seroconverted during this study (incidence = 3.1/1000 person-month). In 1.8% (5/281) of cases, RNA was detected before the appearance of antibodies (up to 5 months), and in 1.1% (3/281) of cases, RNA was the unique marker of HCV infection. The genotypes found were 1a, 1b, 3a, and 4a. The presence of genotype 4a is noteworthy, since it is a rare genotype in Brazil. These data pointed out the high prevalence and incidence of HCV infection at hemodialysis centers in Brazil and showed that routine PCR is fundamental for improving the detection of HCV carriers among patients undergoing hemodialysis.Key words: HCV genotypes, hemodialysis, hepatitis C, PCR, prevalence, incidence.

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Characterization of Occult Hepatitis C Virus (Hcv) Infection among Hemodialysis Patient

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v16i1.1138 ◽

2017 ◽

Vol 16 (1) ◽

Author(s):

Siti Nurul Fazlin Abdul Rahman ◽

Hairul Aini binti Hamzah ◽

Mohammed Imad Mustafa ◽

Mohamed Hadzri Hasmoni

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Hemodialysis Patients ◽

Hcv Infection ◽

Viral Rna ◽

Cell Counting ◽

Hcv Rna ◽

Viral Rnas ◽

Occult Hepatitis ◽

Occult Hepatitis C

Introduction: The existence of new entity called occult hepatitis C virus (HCV) has become a raising and escalating concern among healthcare professionals worldwide. It is defined by the presence of viral RNA in liver and/or peripheral blood mononuclear cells (PBMCs) within non HCV-infected patients. Previous study had shown the occult HCV is infectious and capable of transmitting the virus to another host. Till today, HCV infection remains common among hemodialysis patients despite having the best preventive plans. Because of this, there is a significant concern about the source of viral transmission. The aim of the study was to identify and characterize occult HCV infection in PBMC sample of hemodialysis patients. This was an observational and cross sectional study. Materials and method: PBMCs were isolated from the whole blood using Ficoll-gradient centrifugation technique. The PBMCs were then subjected for cell counting and stored in -70O C until further used. HCV RNA were extracted from these cells and viral RNA were subjected for molecular assays, immune cells analysis and cells culture. Results: PBMCs were isolated from eleven (11) study patients and five (5) anti-HCV positive (control) patients. By using automated flow cytometry, PBMCs of each sample were counted and the average number of cells obtained range from 2x104 to 5x106 cells/ ml. Viral RNAs were extracted and quantitatively measured by using NanoDrop Spectrophotometers. The viral RNAs concentration obtained were between 24.7 and 258.9 ng/ml. The RNAs would be subjected for purification (ethanol precipitation) and further assays. Conclusion: The final findings might contribute to the clinical management of dialysis patients.

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Patient-Care Practices Associated with an Increased Prevalence of Hepatitis C Virus Infection among Chronic Hemodialysis Patients

Infection Control and Hospital Epidemiology ◽

10.1086/659407 ◽

2011 ◽

Vol 32 (5) ◽

pp. 415-424 ◽

Cited By ~ 29

Author(s):

Gayle Shimokura ◽

Feng Chai ◽

David J. Weber ◽

Gregory P. Samsa ◽

Guo-liang Xia ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Patient Care ◽

The United States ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Hcv Infection ◽

Hcv Rna ◽

Infection Prevalence ◽

Care Practices

Objective.To identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients.Design.Survey.Setting.Chronic hemodialysis facilities in the United States.Participants.Equal-probability 2-stage cluster sampling was used to select 87 facilities from all Medicare-approved providers treating 30–150 patients; 53 facilities and 2,933 of 3,680 eligible patients agreed to participate.Methods.Patients were tested for HCV antibody and HCV RNA. Data on patient-care practices were collected using direct observation.Results.The overall prevalence of HCV infection was 9.9% (95% confidence interval [CI], 8.2%–11.6%); only 2 of 294 HCV-positive patients were detected solely by HCV RNA testing. After adjusting for non-dialysis-related HCV risk factors, patient-care practices independently associated with a higher prevalence of HCV infection included reusing priming receptacles without disinfection (odds ratio [OR], 2.3 [95% CI, 1.4–3.9]), handling blood specimens adjacent to medications and clean supplies (OR, 2.2 [95% CI, 1.3–3.6]), and using mobile carts to deliver injectable medications (OR, 1.7 [95% CI, 1.0–2.8]). Independently related facility covariates were at least 10% patient HCV infection prevalence (OR, 3.0 [95% CI, 1.8–5.2]), patient-to-staff ratio of at least 7: 1 (OR, 2.4 [95% CI, 1.4–4.1]), and treatment duration of at least 2 years (OR, 2.4 [95% CI, 1.3–4.4]).Conclusions.This study provides the first epidemiologic evidence of associations between specific patient-care practices and higher HCV infection prevalence among hemodialysis patients. Staff should review practices to ensure that hemodialysis-specific infection control practices are being implemented, especially handling clean and contaminated items in separate areas, reusing items only if disinfected, and prohibiting mobile medication and clean supply carts within treatment areas.

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PREVALENCE AND GENOTYPING OF HEPATITIS C VIRUS IN HEMODIALYSIS PATIENTS AND EVALUATION OF HCV-CORE ANTIGEN TEST IN SCREENING PATIENTS FOR DIALYSIS IN SANA'A CITY, YEMEN

Universal Journal of Pharmaceutical Research ◽

10.22270/ujpr.v4i2.251 ◽

2019 ◽

Author(s):

Samira H Hanash ◽

Hassan A. Al-Shamahy ◽

Mohammed Hussein Saleh Bamshmous

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

General Population ◽

Predictive Power ◽

Hcv Infection ◽

Health Concern ◽

Core Antigen ◽

Antigen Test ◽

Genotype 4 ◽

Hcv Core Antigen

Hepatitis C virus infection is a constant worldwide public health concern. The prevalence of HCV infection is higher in patients on chronic haemodialysis (HD) than in the general population. Despite the control of blood products, hepatitis C virus transmission is still being observed among patients undergoing dialysis. Detection systems for serum HCV antibodies are insensitive in the acute phase because of the long serological window. Direct detection of HCV depends on PCR test but this test is not suitable for routine screening. The objective of this study was to determine prevalence of HCV, genotyping and if HCV core antigen test could be a better alternative to NAT techniques for the diagnosis of HCV infection during the window period and whether the sensitivity for antibody detection is preserved. We screened 159 patients on long-term dialysis by HVC antibodies test, PCR HCV-RNA and HCV core antigen test by commercial tests. The prevalence of HCV was 10.7% (17 patients) and genotype 4 was the most common one (64.7%). The sensitivity of HCV core antigen test was 94.1%, the specificity 100%, the positive predictive power 100%, and the negative predictive power 97.9%. In conclusions; patients on maintenance HD in Yemen have a high prevalence of HCV infection comparing with general population; and genotype 4 is predominant. The performance of serological detection of HCV core antigen was better than that of HCV antibodies test and may be an alternative to nucleic acid amplification technology (NAT) for routine monitoring of patients on chronic dialysis.

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Evaluation of an Isolation Program of Hepatitis C Virus Infected Hemodialysis Patients in Some Hemodialysis Centers in Egypt

ISRN Nephrology ◽

10.5402/2013/395467 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Amin R. Soliman ◽

Mohamed Momtaz Abd Elaziz ◽

Mona I. El lawindi

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Hemodialysis Patients ◽

Hcv Infection ◽

The Other ◽

Nosocomial Transmission ◽

Universal Prevention ◽

Prevention Measures ◽

High Prevalence ◽

Regular Hemodialysis

Introduction. Hepatitis C virus (HCV) infection is a significant cause of morbidity and mortality in hemodialysis (HD) patients. Several studies demonstrated nosocomial transmission of HCV among HD patients. Aim. We aimed to evaluate the isolation program of HCV seropositive patients among a group of Egyptian haemodialysis patients to decrease the incidence of HCV seroconversion. Methods. One hundred and fourteen HCV seronegative patients who were receiving regular haemodialysis in different four haemodialysis units in Egypt. The first group included forty six patients on regular hemodialysis in two centers following strict isolation of the HCV seropositive patients, and the second group included sixty eight patients on regular hemodialysis in the other two centers not following this strict isolation. All these patients were followed up over a period of 36 months. Results. There was a significantly higher incidence of HCV seroconversion of patients on hemodialysis in units not following strict isolation of HCV seropositive patients (42.9%) than those on regular hemodialysis in units following strict isolation (14.8%). Conclusions. In HD units with a high prevalence of HCV+ patients, strict isolation of HCV+ patients in combination with implementation of universal prevention measures can limit the spread of HCV infection in HD patients.

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The Efficacy and Safety of Sofosbuvir/Daclatasvir Fixed-Dose Combination in Iranian Hemodialysis Patients with Hepatitis C Virus Infection

Nephro-Urology Monthly ◽

10.5812/numonthly.114049 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Kasra Ghanaat ◽

Heidar Sharafi ◽

Seyed Moayed Alavian

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Renal Impairment ◽

Severe Renal Impairment ◽

Hemodialysis Patients ◽

Virologic Response ◽

Hcv Infection ◽

Fixed Dose ◽

Efficacy And Safety ◽

Patient Reported

Background: Although several regimens have been approved for the treatment of hepatitis C virus (HCV) infection, sofosbuvir-based regimens are not approved for the treatment of HCV infection in patients with severe renal impairment. Methods: This study was conducted on 51 hemodialysis patients infected with HCV. The patients received a constant dose of sofosbuvir/daclatasvir (SOF/DCV). Sustained virologic response (SVR) was evaluated 12 weeks after completion of treatment. The subjects were selected and treated with a combination of SOF/DCV. Eleven patients expired during the anti-HCV treatment due to causes not related to liver disease or antiviral therapy. Results: Finally, 40 patients finished the treatment, and 36 cases were evaluated for SVR. Among those tested for SVR, 35 (97.2%, 95% CI: 85.5 - 99.9%) achieved SVR and one (2.8%, 95% CI: 0.1 - 14.5%) relapsed. No patient reported severe adverse events. Conclusions: The combination of SOF/DCV showed great efficacy and safety in hemodialysis patients with severe renal impairment and chronic HCV infection.

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Chronic hepatitis C virus infection: Is there a correlation between HCV genotypes and the level of viremia?

Medicinski pregled ◽

10.2298/mpns0606230d ◽

2006 ◽

Vol 59 (5-6) ◽

pp. 230-234 ◽

Cited By ~ 2

Author(s):

Dragan Delic ◽

Zorica Nesic ◽

Jasmina Simonovic ◽

Neda Svirtlih ◽

Ljubisa Dokic ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Objective Assessment ◽

Hcv Infection ◽

Hcv Rna ◽

Genotype 4 ◽

Hcv Genotypes ◽

Genotype 2 ◽

Chronic Hcv Infection ◽

Chronic Hcv

Introduction. Hepatitis C virus (HCV) RNA status and HCV genotypes have become extremely important for exact diagnosis, prognosis, duration of treatment and monitoring of antiviral therapy of chronic HCV infection. Material and methods. For the purpose of precise and objective assessment of virologic analyses, such as the determination of the number of virus copies and virus genotypes, 110 patients with chronic HCV infection were tested. Genotyping of HCV isolates and HCV RNA quantification were performed by using the PCR method. Genotype lb infection was verified in 49.1% of patients, genotype 3a infection was found in 28.2%, genotype 4 in 9.1%, genotype 2 in 4.5%, while mixed genotype infections were diagnosed in 9.1% of cases. Results. Patients infected by genotype lb had significantly higher serum HCV RNA level in relation to patients infected by other genotypes (p<0.05). Over 70% of patients infected by genotype lb had more than 2xl06 virus copies in 1 ml of blood, while in genotypes 2, 3a and 4, the percentage was 40%, 38.5% and 30%, respectively. Male patients had approximately 7.7x10.6 virus copies in 1 ml of blood, which was significantly higher in comparison with female patients (2.3xl06 copies/ml; p<0.05). Conclusion. Our results are in concordance with the results of other authors reporting that genotype lb is predominant in Europe, as well as significantly higher incidence of viremia in patients with genotype lb infection in relation to other HCV genotypes. Based on these results, we can conclude that our patients, most commonly, present with severe clinical course of chronic HCV infection and require longer treatment (48 weeks), which causes economic problems. .

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