9
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Eficacia del aislamiento de pacientes con hepatitis por virus C en hemodiálisis Translated title: Effectiveness of the isolation of patients with hepatitis C virus (HCV) in the hemodialysis unit

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          La infección por el virus de la hepatitis C (VHC) es una complicación frecuente en los pacientes con insuficiencia renal crónica (IRCT) sometidos a hemodiálisis (HD) periódica y se plantean como principales vías de transmisión a las transfusiones de sangre y la vía nosocomial. Se realizó un estudio analítico de cohorte retrospectivo en la Unidad de Diálisis del Instituto Superior de Medicina Militar “Dr. Luís Díaz Soto” entre 1995 y 2000, con el objetivo de analizar la incidencia por año de la infección por el VHC en los pacientes hemodializados y su asociación causal con diferentes variables como: proximidad física y cumplimiento de las medidas universales. Se dividió el periodo de estudio en 5 estratos, se analizó una muestra de 53 pacientes a los que se le determinó anti-HVC por Elisa de segunda y tercera generación todos los meses. El análisis de la prevalencia por periodos de estudio demostró un aumento desde el 12,5 % en el periodo de 1995-1996 hasta el 31 % en 1999-2000. La tasa global de incidencia fue de 1,01 por 100 meses/pacientes, con un nivel máximo en el periodo de 1997-1998 (2,6/100 meses pacientes); después de aislar a los pacientes y de reforzar el cumplimiento de las medidas universales la incidencia disminuyó a 1,5 y 0,4 en los periodos 1998-1999 y 1999-2000 respectivamente. El cumplimiento de las medidas de tratamiento para la prevención de la transmisión del VHC en HD es necesario y efectivo para disminuir la incidencia de esta infección, pero estas medidas por si solas no resuelven el problema y las medidas de aislamiento deben ser tomadas en dependencia de las particularidades de cada centro de diálisis.

          Translated abstract

          Hepatitis C virus infection (HCV) is a frequent complication in patients presenting chronic renal failure (CRF) that undergo periodical hemodialysis. The main transmission routes are blood transfusions and the nosocomial route. An analytical retrospective cohort study was undertaken in the Dialysis Unit of the Higher Institute of Military Medicine from 1995 to 2000 to analyze the incidence of HCV infection per year in hemodyalysis patients and its association with different variables as physical closeness and fulfilment of universal measures. The study period was divided into 5 strata. A sample of 53 patients was analyzed and anti-HCV was determined by second and third generation ELISA every month. The analysis of prevalence per study period showed an increase from 12.5 % in 1995-1996 to 31 % in 1999-2000. The global rate of incidence was 1.01 per 100 months/patients, with a maximum level between 1997 and 1998 (2.6/100 months/patients). After isolating the patients and reinforcing the fulfilment of universal measures, the incidence decreased to 1,5 and 0,4 in 1998-1999 and 1999-2000, respectively. The fulfilment of the treatment measures related to prevention of HCV transmission in hemodialysis is necessary and effective to decrease the incidence of this infection, but these measures by themselves do not solve the problem, and isolation measures should be taken depending on the particularities of each dialysis center.

          Related collections

          Most cited references38

          • Record: found
          • Abstract: found
          • Article: not found

          Patterns of hepatitis C prevalence and seroconversion in hemodialysis units from three continents: the DOPPS.

          Hepatitis C virus (HCV) remains a problem within hemodialysis units. This study measures HCV prevalence and seroconversion rates across seven countries and investigates associations with facility-level practice patterns. The study sample was from the Dialysis Outcomes and Practice Patterns Study (DOPPS), a prospective, observational study of adult hemodialysis patients randomly selected from 308 representative dialysis facilities in France, Germany, Italy, Japan, Spain, the United Kingdom, and the United States. Logistic regression was used to model odds of HCV prevalence, and Cox regression was used to model time from study entry to HCV seroconversion. Mean HCV facility prevalence was 13.5% and varied among countries from 2.6% to 22.9%. Increased HCV prevalence was associated with longer time on dialysis, male gender, black race, diabetes, hepatitis B (HBV) infection, prior renal transplant, and alcohol or substance abuse in the previous 12 months. Approximately half of the facilities (55.6%) had no seroconversions during the study period. HCV seroconversion was associated with longer time on dialysis, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), HBV infection, and recurrent cellulitis or gangrene. An increase in highly trained staff was associated with lower HCV prevalence (OR = 0.93 per 10% increase, P= 0.003) and risk of seroconversion (RR = 0.92, P= 0.07). Seroconversion was associated with an increase in facility HCV prevalence (RR = 1.36, P < 0.0001), but not with isolation of HCV-infected patients (RR = 1.01, P= 0.99). There are differences in HCV prevalence and rate of seroconversion at the country and the hemodialysis facility level. The observed variation suggests opportunities for improved HCV outcomes.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Prevalence and risk factors of hepatitis C virus infection in haemodialysis patients: a multicentre study in 2796 patients.

            Hepatitis C virus (HCV) infection is a significant problem in the management of haemodialysis patients. A high prevalence of HCV infection in haemodialysis patients has been reported. Risk factors such as the number of blood transfusions or duration on haemodialysis have been identified. To determine the prevalence of HCV by antibody testing and HCV-RNA determination by polymerase chain reaction (PCR) in haemodialysis patients. Furthermore, liver function tests were performed and epidemiological data were obtained to determine risk factors for HCV in this cohort of patients. A total of 2796 patients from 43 dialysis centres were enrolled. The overall prevalence of HCV (HCV antibody and/or HCV-RNA positivity) was 7.0% (195 patients). Antibody positivity occurred in 171 patients (6.1%). Viraemia was detectable in 111 patients (4.0%). Twenty four of 111 HCV RNA positive patients (21.6%) were negative for HCV antibodies. Thus 0.8% of the entire study population was HCV positive but could not be diagnosed by routine HCV antibody testing. Major risk factors identified by a standard questionnaire in 1717 of 2796 patients were the number of blood transfusions individuals had received and duration of dialysis, the latter including patients who received no blood transfusions. Sequencing of the 5'untranslated region of the genome showed a dominant genotype 1 (77.6%) within the cohort. Further reverse transcription-PCR of the NS5b and core region were performed to document phylogenetic analysis. Comparing nucleic acid sequences detected by PCR, no homogeneity was found and thus nosocomial transmission was excluded. HCV is common in German haemodialysis patients but screening for HCV antibodies alone does not exclude infection with HCV.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Hepatitis C virus infections and genotypes in China.

              To define the conditions of hepatitis C virus (HCV) infections, and geographic and demographic distributions of genotypes in China. HCV infected patients were selected from individuals with different patterns of liver diseases and high risk populations in different parts of China. Genotypes of HCV in some isolates were further analyzed, based on the data from our laboratory studies and some carefully selected published literatures. The anti-HCV positive rates were 9.7% in patients with acute hepatitis, 13.3% in patients with chronic hepatitis, 18.3% in patients with hepatocellular carcinoma, 33.0% in patients with liver cirrhosis, and 43.2% in patients with posttransfusional hepatitis (average, 16.2% in patients with liver diseases). The anti-HCV positive rates in the high risk populations were 36.4% in leukemic patients, 43.0% in hemodialysis patients, 12.7% in blood donors, 64.1% in drug abusers, 13.1% in prostitutes, and 2.57% in naturally healthy people. At least 4 clades (clades 1, 2, 3 and 6) of HCV were found in China with different geographic and demographic distributions. Genotype 1b was the most widely distributed genotype, and genotype 3 was mainly found in Yunnan Province, Southwest China. China has a high incidence of HCV infection. Our results will provide a strategic basis for diagnosis, treatment and possibly prophylaxis of hepatitis C virus diseases.
                Bookmark

                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                mil
                Revista Cubana de Medicina Militar
                Rev Cub Med Mil
                ECIMED (Ciudad de la Habana )
                1561-3046
                March 2006
                : 35
                : 1
                : 0
                Affiliations
                [1 ] Instituto Superior de Medicina Militar Dr. Luis Díaz Soto Cuba
                Article
                S0138-65572006000100005
                e4101df4-52a1-4933-93b7-83f78a7e526b

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Cuba

                Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=0138-6557&lng=en
                Categories
                MEDICINE, LEGAL
                MEDICINE, RESEARCH & EXPERIMENTAL

                Social law,Medicine
                Hemodialysis,hepatitis C virus,seroprevalence,terminal chronic renal failure,Hemodiálisis,hepatitis viral tipo C,seroprevalencia,insuficiencia renal crónica terminal

                Comments

                Comment on this article