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Incidence and patterns of hepatitis C virus seroconversion in a cohort of hemodialysis patients

Citation:

Sypsa V, Psichogiou M, Katsoulidou A, Skoutelis G, Moutafis S, Hadjiconstantinou V, Kakavas J, Kalapothaki V, Boletis J, Hatzakis A. Incidence and patterns of hepatitis C virus seroconversion in a cohort of hemodialysis patients. Am J Kidney DisAm J Kidney DisAm J Kidney Dis. 2005;45:334-43.

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.

Notes:

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.