Hepatitis C prevalence and risk factors in hemodialysis patients in central Brazil: a survey by polymerase chain reaction and serological methods
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2001-08
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An hemodialysis population in Central Brazil was screened by polymerase chain reaction (PCR) and serological methods to assess the prevalence of hepatitis C virus (HCV) infection and to investigate associated risk factors. All hemodialysis patients (n=428) were interviewed in eight dialysis units in Goiânia city. Blood samples were collected and serum samples screened for anti-HCV antibodies by an enzyme-linked immunosorbent assay (ELISA). Positive samples were retested for confirmation with a line immunoassay (LIA). All samples were also tested for HCV RNA by the PCR. An overall prevalence of 46.7% (CI 95%: 42-51.5) was found, ranging from 20.7% (CI 95%: 8.8-38.1) to 90.4% (CI 95%: 79.9-96.4) depending on the dialysis unit. Of the 428 patients, 185 were found to be seropositive by ELISA, and 167 were confirmed positive by LIA, resulting in an anti-HCV prevalence of 39%. A total of 131 patients were HCV RNA-positive. HCV viremia was present in 63.5% of the anti-HCV-positive patients and in 10.3% of the anti-HCV-negative patients. Univariate analysis of risk factors showed that the number of previous blood transfusions, transfusion of blood before mandatory screening for anti-HCV, length of time on hemodialysis, and treatment in multiple units were associated with HCV positiv-ity. However, multivariate analysis revealed that blood transfusion before screening for anti-HCV and length of time on hemodialysis were significantly associated with HCV infection in this population. These data suggest that nosocomial transmission may play a role in the spread of HCV in the dialysis units studied. In addition to anti-HCV screening, HCV RNA detection is necessary for the diagnosis of HCV infection in hemodialysis patients.
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Central Brazil, Hepatitis C, Hemodialysis, Prevalence, Risk factors
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CARNEIRO, Megmar A. S.; MARTINS, Regina M. B.; TELES, Sheila A.; SILVA, Simonne A.; LOPES, Carmen L.; CARDOSO, Divina D. P.; VANDERBORGHT, Bart O. M.; YOSHIDA, Clara F. T. Hepatitis C prevalence and risk factors in hemodialysis patients in central Brazil: a survey by polymerase chain reaction and serological methods. Memórias do Instituto Oswaldo Cruz, Rio de Janeiro, v. 96, n. 6, p. 765-769, 2001.