hepatitis c virus infection and hcv genotypes of hemodialysis patients

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.