Hand contamination with hepatitis C virus in staff looking after hepatitis C-positive hemodialysis patients.
BACKGROUND
Hepatitis C virus (HCV) is a major cause of hepatitis in hemodialysis (HD) patients. Routes other than blood transfusion play a role in the spread of HCV in HD patients. Molecular studies of HCV implicate nosocomial transmission of the virus in HD units. We conducted a clinicovirological study in our HD unit to investigate if the hands of dialysis personnel could represent a mode of transmission of HCV among HD patients.


METHODS
One liter of sterile water was used for each handwashing of dialysis personnel. The washing was collected in a sterile container and tested for HCV-RNA by polymerase chain reaction (PCR) within 3 h of collection. Eighty handwashings from nurses dialyzing HCV-positive patients (groupe A) and 100 handwashing from nurses dialyzing HCV-negative patients (group B) were tested for HCV-RNA. As a control, 60 handwashings were collected from the dialysis personnel before entering the dialysis unit (group C) and tested for HCV-RNA.


RESULTS
HCV-RNA was positive in 19 (23.75%) of samples of group A, in 8 (8%) of samples of group B (p < 0.003) and in 2 (3.3%) of samples of group C (p < 0. 35). These two positive samples of group C were from nurses who had dialyzed HCV-negative patients.


CONCLUSIONS
These results indicate the presence of HCV-RNA on the hands of some dialysis personnel in our HD unit, in spite fo adherence to the standard precautions. The hands of dialysis personnel are therefore a potential mode for facilitating transmission of HCV between HD patients.
Alfurayh
O
O
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. osman@kfshrc.edu.sa
Sabeel
A
A
Al Ahdal
M N
MN
Almeshari
K
K
Kessie
G
G
Hamid
M
M
Dela Cruz
D M
DM
D003428:Cross Infection / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D017931:DNA Primers / Q000737:chemistry; D006225:Hand / Q000821:virology*; D006235:Hand Disinfection; D006436:Hemodialysis Units, Hospital; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D006526:Hepatitis C / Q000635:transmission* / Q000821:virology; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D009722:Nurse Practitioners; D012367:RNA, Viral / Q000032:analysis; D006435:Renal Dialysis; D020133:Reverse Transcriptase Polymerase Chain Reaction
D017931:DNA Primers; D018937:Hepatitis C Antibodies; D012367:RNA, Viral