Hepatitis C Virus Infection and HCV Genotypes of Hemodialysis Patients

Abstract

Background: To evaluate the prevalence of hepatitis C by antibody testing, HCV-RNA detection by PCR and relative risk fac­tors of HCV infection among HD patients and staff members in Markazi Province/Iran. The other purpose was to deter­mine genotypes of HCV in this population.
Methods: The study group consisted of 204 HD patients and 47 staff members from all 9 dialysis centers in Markazi Prov­ince, Iran. Anti-HCV antibodies were tested using a third generation ELISA and confirmed by RIBA. HCV RNA was deter­mined by RT-PCR and genotyping was performed by a reverse hybridization assay (LiPA).
Results: The overall prevalence of HCV (HCV antibody and HCV-RNA) was 5.4%. Female sex (P= 0.019), duration of dialy­sis (P= 0.003) and kidney transplant (P= 0.049) were significantly correlated with HCV infection. The predominant sub­type was HCV-1a, detected in 4(50%) of the 8 HD patients. Genotype 4, 3a and 1b were found in 2(25%), 1(12.5%) and 1(12.5%) patients respectively.  The prevalence of anti-HCV among staff members of HD units was 0%.
Conclusion: The presence of anti HCV positive patients who had never been transfused, high prevalence of genotype 4 in this population, duration of HD as a risk factor for HCV positivity and non significant association between blood transfu­sion and HCV infection suggest nosocomial transmission of the virus in dialysis units that needs to be confirmed by phyloge­netic analysis of subgenomic regions of HCV. HD staff members dose not seem to be at increased risk of hepatitis C de­spite the frequent blood exposure and lack of strict adherence to universal infection control precautions.