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      Acute hepatitis C virus infection assessment among chronic hemodialysis patients in the Southwest Parana State, Brazil

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          Chronic hemodialysis patients are at higher risk for acquiring hepatitis C virus (HCV). The prevalence varies among different countries and hemodialysis centers. Although guidelines for a comprehensive infection control program exist, the nosocomial transmission still accounts for the new cases of infection. The aim of this study was analyze the follow up of newly acquired acute hepatitis C cases, during the period from January 2002 to May 2005, in the Hemodialysis Center, located in the Southwest region of Parana State, Brazil and to analyze the effectiveness of the measures to restrain the appearance of new cases of acute hepatitis C.


          Patients were analyzed monthly with anti-HCV tests and ALT measurements. Patients with ALT elevations were monitored for possible acute hepatitis C.


          During this period, 32 new cases were identified with acute hepatitis C virus infection. Blood screening showed variable ALT levels preceding the anti-HCV seroconversion. HCV RNA viremia by PCR analysis was intermittently and even negative in some cases. Ten out of 32 patients received 1 mcg/kg dose of pegylated interferon alfa-2b treatment for 24 weeks. All dialysis personnel were re-trained to strictly follow the regulations and recommendations regarding infection control, proper methods to clean and disinfect equipment were reviewed and HCV-positive patients were isolated.


          Laboratory tests results showed variable ALT preceding anti-HCV seroconversion and intermittent viremia. The applied recommendations contributed importantly to restrain the appearance of new cases of acute hepatitis C in this center and the last case was diagnosed in May 2004.

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          Most cited references 27

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          Single step method of RNA isolation by acid guanidium thiocyanate phenol chloroform extraction. Anal

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            Recommendations for preventing transmission of infections among chronic hemodialysis patients.

            These recommendations replace previous recommendations for the prevention of bloodborne virus infections in hemodialysis centers and provide additional recommendations for the prevention of bacterial infections in this setting. The recommendations in this report provide guidelines for a comprehensive infection control program that includes a) infection control practices specifically designed for the hemodialysis setting, including routine serologic testing and immunization; b) surveillance; and c) training and education. Implementation of this program in hemodialysis centers will reduce opportunities for patient-to-patient transmission of infectious agents, directly or indirectly via contaminated devices, equipment and supplies, environmental surfaces, or hands of personnel. Based on available knowledge, these recommendations were developed by CDC after consultation with staff members from other federal agencies and specialists in the field who met in Atlanta on October 5-6, 1999. They are summarized in the Recommendations section. This report is intended to serve as a resource for health-care professionals, public health officials, and organizations involved in the care of patients receiving hemodialysis.
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              National Institutes of Health Consensus Development Conference Statement: Management of hepatitis C: 2002--June 10-12, 2002.


                Author and article information

                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                4 April 2007
                : 7
                : 50
                [1 ]Department of Gastroenterology, Hepatology Branch, University of São Paulo, School of Medicine, São Paulo, Brazil
                Copyright © 2007 Engel et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Research Article

                Public health


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