[Prevalence and associated factors to hepatitis C in hemodialysis patients in Brazil].
OBJECTIVE
The prevalence of hepatitis C virus (HCV) is higher in patients on hemodialysis than in the general population, probably due to greater exposure to risk situations. The purposes of the study were to determine anti-HCV antibodies prevalence among hemodialysis patients and dialysis clinics and patients factors associated with HCV transmission.


METHODS
A cross-sectional study was conducted in 752 hemodialysis patients in all 12 dialysis clinics of Fortaleza, Brazil, and were screened using third generation ELISA. Sociodemographic, clinical, and epidemiological data of 663 patients were collected through interviews. Nosocomial factors were assessed using a specific questionnaire tool. Statistical analysis was conducted using Student's t test, odds ratio and multivariate analysis.


RESULTS
The prevalence of anti-HCV was 52% (390/746; ranged from 6% to 72%). The anti-HCV positivity was higher in patients who had previous peritoneal dialysis (OR=1.76; 95% CI 1.12-2.76) and blood transfusion (OR=2.75; 95% CI 1.25-6.03). Dialysis age has been associated with anti-HCV positivity (OR=1.47; 95% CI 1.35-1.61). Clinics practices associated with anti-HCV positivity were: previous preparing of heparin (OR=2.92; 95% CI 1.23-6.92), failure in gloves use or change (OR=5.73; 95% CI 1.75-18.72), unsatisfactory dialysis machine disinfection (OR=2.79; 95% CI 1.57-4.96), and patient isolation in dialysis room (OR=0.18; 95% CI 0.05-0.61).


CONCLUSIONS
The results show high anti-HCV prevalence among hemodialysis patients and the association of nosocomial factors with new HCV infection cases.
Medeiros
Maria Teresa Gonçalves de
MT
Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil. mtgmce@yahoo.com.br
Lima
José Milton de Castro
JM
Lima
José Wellington de Oliveira
JW
Campos
Henry de Holanda
Hde H
Medeiros
Marta Maria das Chagas
MM
Coelho Filho
João Macedo
JM
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003428:Cross Infection / Q000453:epidemiology / Q000635:transmission; D004797:Enzyme-Linked Immunosorbent Assay; D004812:Epidemiologic Methods; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D012959:Socioeconomic Factors
D015415:Biomarkers; D018937:Hepatitis C Antibodies