Hepatitis C virus infection in four haemodialysis units of southern Italy: epidemiological report.
The haemodialysis patients are an high risk population for hepatitis viral infections. While the incidence of HBV has decreased worldwide, HCV is now the major cause of viral infection in these patients. The aim of our study was to define a complete map of patients undergoing routine replacement therapy by haemodialysis in the province of Foggia, Southern Italy, who were HCV Ab positive, the presence of viraemia and their genotypes; moreover, we investigated the probable factors involved in determining the infection as well as the means of prevention.


METHODS
We enrolled 330 patients treated in four haemodialysis centres (DC) and six secondary units; mean age was 57 years and mean duration of dialysis 76 months. Samples were drawn to determine cytolysis indexes and the HCV Ab status; in HCV positive patients, we also looked for viraemia and HCV genotypes. Data were analysed by a transversal cross-section study.


CONCLUSIONS
Prevalence of HCV infection was 0.43 (males 0.45, females 0.42). The risk of contracting the infection was shown to be significantly different in the various DCs and did not seem to be related to the severity of the preventive measures. There was no significant difference between the various DCs in the comparison between the odds of HCV-RNA+ and HCV-RNA- patients. No significant prevalence of a given genotype emerged from a cross-sectional study related to the comparison between different genotypes. Moreover, transfusions of blood products seemed to have no significant relation to HCV infection. Finally, patients treated with haemodialysis for more than 36 months run a seven time greater risk of contracting HCV infection.
Department of Infectious Diseases, II Laboratory, Foggia, Italy.
G
G
Scotto
F
F
Avcella
M
M
Panunzio
A M
AM
Savastano
M
M
Ktena
M
M
Forcella
V
V
Fazio
G
G
Calzone
A
A
Passione
D
D
Procaccini
A
A
Demin
C
C
Stallone
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006436:Hemodialysis Units, Hospital / Q000706:statistics & numerical data*; D016174:Hepacivirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D013223:Statistics as Topic; D014766:Viremia / Q000453:epidemiology*