Systemic Diseases and the Kidney RISK FACTORS IN THE POPULATION WITH END-STAGE RENAL DISEASE AND HEPATITIS C VIRUS INFECTION

Reuse [71,72] FIGURE 7-7 Risk of HCV in the ESRD population. Numerous studies have demonstrated a strong association between the prevalence of hepatitis C virus (HCV) infection among patients receiving dialysis and both the number of transfusions received and duration of dialysis [53,61]. Although these two variables are related, the prevalence of anti-HCV in these patients has been shown to be independently associated with both factors by regression analysis. In contrast to patients receiving hemodialysis, patients receiving peritoneal dialysis consistently have a lower prevalence of anti-HCV antibody [60–70]. Moreover, units with a low prevalence of anti-HCV have been shown to have a lower seroconversion rate [71]. The latter two observations coupled with the independent association of duration of dialysis with seropositivity argue in favor of nosocomial transmission of HCV in hemodialysis units. This conclusion is further supported by data showing a decreased incidence of HCV seroconversion in dialysis units employing isolation and dedicated equipment for patients who test positive for HCV infection [72].