Figure 77

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 hemo-dialysis 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].

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