Updated Evidence on the Epidemiology of Hepatitis C Virus in Hemodialysis
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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-09-01
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| Series: | Pathogens |
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| Online Access: | https://www.mdpi.com/2076-0817/10/9/1149 |
| _version_ | 1797517686180151296 |
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| author | Fabrizio Fabrizi Roberta Cerutti Piergiorgio Messa |
| author_facet | Fabrizio Fabrizi Roberta Cerutti Piergiorgio Messa |
| author_sort | Fabrizio Fabrizi |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T07:19:39Z |
| format | Article |
| id | doaj.art-cf174fba9a0641c7a50ea506b7761722 |
| institution | Directory Open Access Journal |
| issn | 2076-0817 |
| language | English |
| last_indexed | 2024-03-10T07:19:39Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pathogens |
| spelling | doaj.art-cf174fba9a0641c7a50ea506b77617222023-11-22T14:42:29ZengMDPI AGPathogens2076-08172021-09-01109114910.3390/pathogens10091149Updated Evidence on the Epidemiology of Hepatitis C Virus in HemodialysisFabrizio Fabrizi0Roberta Cerutti1Piergiorgio Messa2Department of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyPrevalence 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.https://www.mdpi.com/2076-0817/10/9/1149hepatitis C virushemodialysisincidenceinfection control practicesprevalencetransmission |
| spellingShingle | Fabrizio Fabrizi Roberta Cerutti Piergiorgio Messa Updated Evidence on the Epidemiology of Hepatitis C Virus in Hemodialysis Pathogens hepatitis C virus hemodialysis incidence infection control practices prevalence transmission |
| title | Updated Evidence on the Epidemiology of Hepatitis C Virus in Hemodialysis |
| title_full | Updated Evidence on the Epidemiology of Hepatitis C Virus in Hemodialysis |
| title_fullStr | Updated Evidence on the Epidemiology of Hepatitis C Virus in Hemodialysis |
| title_full_unstemmed | Updated Evidence on the Epidemiology of Hepatitis C Virus in Hemodialysis |
| title_short | Updated Evidence on the Epidemiology of Hepatitis C Virus in Hemodialysis |
| title_sort | updated evidence on the epidemiology of hepatitis c virus in hemodialysis |
| topic | hepatitis C virus hemodialysis incidence infection control practices prevalence transmission |
| url | https://www.mdpi.com/2076-0817/10/9/1149 |
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