Isolation effectively prevents the transmission of hepatitis C virus in the hemodialysis unit

Chwei Shiun Yang*, Hsu Hung Chang, Chia Chi Chou, Sheng Jeng Peng

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

32 Scopus citations

Abstract

Background and Purpose: Many preventative strategies have been proposed to control hepatitis C virus (HCV) infection in the hemodialysis unit. The effectiveness of isolation as a preventive policy remains unclear. The aim of this study was to evaluate the effect of an isolation policy on the incidence of hepatitis C in our hemodialysis unit. Methods: A total of 325 hemodialysis patients with a mean age of 62 ± 14 years and a mean duration of dialysis of 4.8 ± 4.4 years, who were treated from January 1993 to December 2000 were included in this retrospective study. Data were collected from medical records. HCV antibody was monitored at 6-month intervals. During the period before September 1997 all patients were dialyzed in a single room. Isolation started after September 1997, when an additional room became available. Patients positive for either hepatitis B or C were clustered in 1 area (Area 1). Anti-HCV-negative and hepatitis B surface antigen (HBsAg)-negative patients were assigned either to a segregated zone (Area 2) adjacent to Area 1 in the same room or to a separate independent room (Area 3). Dialyzers were not reused and hygienic precautions remained the same throughout the study period. Results: Forty months after the implementation of the isolation policy, there was significant reduction in the total prevalence (49.7 vs 31.7%, p < 0.01) and incidence (9.1 vs 2.9% patient-years, p < 0.01) of HCV infection. Seroconversion of anti-HCV was detected in 9 patients, 7 in Area 1, 2 in Area 2, with no new cases in Area 3. The incidence of seroconversion of anti-HCV was significantly different in the 3 areas. Regression analysis indicated that isolation was the most prominent independent factorin reducing seroconversion of anti-HCV. Conclusions: These results support the use of an isolation policy to combat HCV infection among hemodialysis patients, particularly in high prevalence units.

Original languageEnglish
Pages (from-to)79-85
Number of pages7
JournalJournal of the Formosan Medical Association
Volume102
Issue number2
StatePublished - 01 02 2003
Externally publishedYes

Keywords

  • Hepatitis C
  • Infection control
  • Patient isolation
  • Renal dialysis

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