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Review
. 2021 Sep 7;10(9):1149.
doi: 10.3390/pathogens10091149.

Updated Evidence on the Epidemiology of Hepatitis C Virus in Hemodialysis

Fabrizio Fabrizi  1 , Roberta Cerutti  1 , Piergiorgio Messa  1   2
Affiliations
Review

Updated Evidence on the Epidemiology of Hepatitis C Virus in Hemodialysis

Fabrizio Fabrizi et al. Pathogens. .

Abstract

Prevalence rates of HCV infection are decreasing in hemodialysis units of most developed countries; however, nosocomial transmission of HCV continues to occur in the hemodialysis setting, not only in the emerging world. According to the Dialysis Outcomes and Practice Patterns Study (DOPPS, 2012-2015), the prevalence of HCV among patients on regular hemodialysis was 9.9%; in incident patients, the frequency of HCV was approximately 5%. Outbreaks of HCV have been investigated by epidemiologic and phylogenetic data obtained by sequencing of the HCV genome; no single factor was retrieved as being associated with nosocomial transmission of HCV within hemodialysis units. Transmission of HCV within HD units can be prevented successfully by full compliance with infection control practices; also, antiviral treatment and serologic screening for anti-HCV can be useful in achieving this aim. Infection control practices in hemodialysis units include barrier precautions to prevent exposure to blood-borne pathogens and other procedures specific to the hemodialysis environment. Isolating HCV-infected hemodialysis patients or using dedicated dialysis machines for HCV-infected patients are not currently recommended; reuse of dialyzers of HCV-infected patients should be made, according to recent guidelines. Randomized controlled trials regarding the impact of isolation on the risk of transmission of HCV to hemodialysis patients have not been published to date. At least two studies showed complete elimination of de novo HCV within HD units by implementation of strict infection control practices without isolation practices. De novo HCV within hemodialysis units has been independently associated with facility HCV prevalence, dialysis vintage, and low staff-to-patient ratio. Antiviral treatment of HCV-infected patients on hemodialysis should not replace the implementation of barrier precautions and other routine hemodialysis unit procedures.

Keywords: hemodialysis; hepatitis C virus; incidence; infection control practices; prevalence; transmission.

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Conflict of interest statement

Declare no conflict of interest.

Figures

Figure 1
Figure 1
Overview of infection control practices for preventing HCV infection within hemodialysis units.
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References

    1. Fabrizi F., Dixit V., Messa P. Hepatitis C virus and mortality among patients on dialysis: A systematic review and meta-analysis. Clin. Res. Hepatol. Gastroenterol. 2019;43:244–254. doi: 10.1016/j.clinre.2018.10.009. - DOI - PubMed
    1. Fabrizi F., Messa P., Martin P. Hepatitis B virus infection and the dialysis patient. Semin. Dial. 2008;21:440–446. doi: 10.1111/j.1525-139X.2008.00437.x. - DOI - PubMed
    1. Jadoul M., Bieber B., Martin P., Akiba T., Nwankwo C., Arduino J., Goodkin D., Pisoni R. Prevalence, incidence, and risk factors for hepatitis C virus infection in haemodialysis patients. Kidney Int. 2019;95:939–947. doi: 10.1016/j.kint.2018.11.038. - DOI - PubMed
    1. Jadoul M., Poignet J., Geddes C., Locatelli F., Medin C., Krajewska M., Barril G., Scheurmann E., Sonkodi S., HCV Collaborative Group et al. The changing epidemiology of hepatitis C virus infection in haemodialysis: European multicentre study. Nephrol. Dial. Transpl. 2004;19:904–909. doi: 10.1093/ndt/gfh012. - DOI - PubMed
    1. CDC CDC Urging Dialysis Providers and Facilities to Assess and Improve Infection Control Practices to Stop Hepatitis C Virus Transmission in Patients Undergoing Haemodialysis. [(accessed on 5 February 2016)]; Available online: https://www.whcawicalorg.

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