Introduction: The prevalence of Hepatitis C Virus (HCV) in chronic hemodialysis patients is eight times higher than among the general population. It is estimated between 3 and 65.8% in different studies and countries and is a contributor to mortality in this population. The aim of this study is to define the factors influencing prevalence and seroconversion of HCV in an ambispective study including 15 centers and 163 hemodialysis patients.
Methods: Multicenter ambispective Study including 167 patients treated in 15 dialysis centers in 4 cities and over a period of 8 years. In 2002, all patients underwent determination of liver enzymes, a serological survey and qualitative research of HCV RNA by polymerase chain reaction followed by a genotyping for patients confirmed positive by the method LIPA. Serological status and movement of patients between centers was followed for 8 years. In 2010, the survivors benefit serology of viral hepatitis B and C (4th generation ELISA) with research of viral RNA by PCR.
Results: The mean age of patients at baseline was 51 years of which 11% were diabetic with a mean of 55 months on hemodialysis. The prevalence of HCV was 33.4% with significantly higher ALT in positive patients and genotype 1b was most frequent (54%). Statistical analysis found that the factors of prevalence are: time on hemodialysis, number of units visited (2.2 vs. 3, p<0.001), number of red blood cells transfused (1.5 vs. 2.5, p=0.009) and area of the unit. After 8 years, overall survival was 58.2% with a prevalence of HCV at 26.2%. During follow-up, 7 seroconversion were objectified and the only factor found is the number of centers visited.
Conclusions: These data suggest that nosocomial transmission plays an important role hence the importance of strict implementation of the recommendations of prevention against the transmission of HCV in particular the training of personnel and control the transfer of patients between centers.