title: Outbreak of hemodialysis-associated non-A, non-B hepatitis and correlation with antibody to hepatitis C virus.
abstract: Between January 1987 and October 1988, 35 (45%) of 77 patients undergoing chronic hemodialysis at one unit developed serum alanine aminotransferase (ALT) elevations suggestive of non-A, non-B hepatitis (NANBH). Patients were grouped by level of ALT elevation and presence of other etiologies for liver injury. All dialysis patients and staff were tested for antibody to hepatitis C virus (anti-HCV) by enzyme immunoassay on three occasions, 9 months apart; anti-HCV repeatedly reactive specimens were tested by the HCV neutralization assay. Household and sexual contacts of patients were tested once for anti-HCV. Case-patients were classified on the basis of clinical case definitions as probable, possible, questionable, and noncases, and by anti-HCV testing. Case-patients who had no history of transfusions or parenteral drug use were compared with noncases for common exposures. A total of 35% (27/77) of patients and none (0/24) of staff were anti-HCV-positive. Anti-HCV was found in 82% of probable cases, compared with 44% of possible cases, 44% of questionable cases, and 12% of noncases (P less than 0.01). Neither a common source nor direct person-to-person transmission could be documented; however, inadequate infection control measures demonstrated by lack of glove use and poor handwashing occurred during the exposure period. The incidence of HCV infection in patients over an 18-month period was 5%. Transmission of HCV to household or sexual contacts of patients did not appear to occur.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Hepatitis Branch, National Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333.
authors.forename: M T
authors.initials: MT
authors.lastname: Niu
authors.forename: M J
authors.initials: MJ
authors.lastname: Alter
authors.forename: C
authors.initials: C
authors.lastname: Kristensen
authors.forename: H S
authors.initials: HS
authors.lastname: Margolis
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D003428:Cross Infection / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D004196:Disease Outbreaks / Q000517:prevention & control; D005260:Female; D006508:Hepatitis Antibodies / Q000097:blood; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D006508:Hepatitis Antibodies; D000410:Alanine Transaminase