@article {17423,
	title = {Incidence and patterns of hepatitis C virus seroconversion in a cohort of hemodialysis patients},
	journal = {Am J Kidney DisAm J Kidney DisAm J Kidney Dis},
	volume = {45},
	number = {2},
	year = {2005},
	note = {Sypsa, VanaPsichogiou, MinaKatsoulidou, AntigoniSkoutelis, GregoryMoutafis, SpiridonHadjiconstantinou, ValsamakisKakavas, JohnKalapothaki, ViktoriaBoletis, JohnHatzakis, AngelosengMulticenter Study2005/02/03 09:00Am J Kidney Dis. 2005 Feb;45(2):334-43. doi: 10.1053/j.ajkd.2004.09.021.},
	month = {Feb},
	pages = {334-43},
	abstract = {BACKGROUND: The aim of this multicenter hemodialysis (HD) cohort study is to prospectively investigate the incidence of hepatitis C virus (HCV) infection in Greece from 1993 to 1995 and delineate early virological and serological events associated with HCV seroconversion in the HD setting. METHODS: Sequential serum samples collected weekly from 562 patients were tested biochemically and serologically by means of a second- (EIA-2) and third-generation enzyme immunoassay (EIA-3). All patients with positive antibody to HCV test results (anti-HCV + ) and sequential samples from seroconverting patients were tested for HCV RNA. RESULTS: Anti-HCV prevalence at study entry was 29\% (163 of 562 patients), and viremia was detectable in 110 of 163 anti-HCV + patients (67.5\%). HCV incidence was 6.2 cases/100 person-years. Seroconversions could not be attributed to transfusions after study entry (only 1 patient had been administered transfusion), and HD unit was associated with increased hazard for seroconversion ( P = 0.002), even after adjusting for potential differences among their patients. According to Kaplan-Meier estimation, the median interval by which the HCV RNA assay detected HCV infection earlier than anti-HCV testing was 246 and 154 days for EIA-2 and EIA-3, respectively. Detectable HCV RNA and at least 2 consecutive abnormal alanine aminotransferase levels in the preseroconversion period were observed in 29 of 30 (97\%) and 14 of 32 patients (44\%), respectively. Reductions in HCV RNA levels immediately after seroconversion were transient or did not occur. CONCLUSION: On the grounds of apparent nosocomial transmission, the wide window period of HCV infection in HD patients emphasizes the need for strict adherence to specific infection-control measures in this setting.},
	keywords = {Alanine Transaminase/blood, Antibodies, Viral/blood, Cohort Studies, Cross-Sectional Studies, Female, Follow-Up Studies, Genotype, Hepacivirus/enzymology/genetics/*immunology, Hepatitis C/*epidemiology, Humans, Immunoenzyme Techniques/methods/statistics \& numerical data, Incidence, Male, Middle Aged, Prospective Studies, Renal Dialysis/*adverse effects, Renal Insufficiency/blood/etiology/virology, Risk Factors, RNA, Viral/blood/immunology, Seroepidemiologic Studies},
	isbn = {1523-6838 (Electronic)0272-6386 (Linking)},
	author = {Sypsa, V and Psichogiou, M and Katsoulidou, A and Skoutelis, G. and Moutafis, S. and Hadjiconstantinou, V. and Kakavas, J. and Kalapothaki, V and Boletis, J. and Hatzakis, A}
}
