The role of hemodialysis machines dedication in reducing Hepatitis C transmission in the dialysis setting in Iran: a multicenter prospective interventional study.
BACKGROUND
Hepatitis C virus (HCV) infection is a significant problem among patients undergoing maintenance hemodialysis (HD). We conducted a prospective multi-center study to evaluate the effect of dialysis machine separation on the spread of HCV infection.


METHODS
Twelve randomly selected dialysis centers in Tehran, Iran were randomly divided into two groups; those using dedicated machines (D) for HCV infected individuals and those using non-dedicated HD machines (ND). 593 HD cases including 51 HCV positive (RT-PCR) cases and 542 HCV negative patients were enrolled in this study. The prevalence of HCV infection in the D group was 10.1% (range: 4.6%- 13.2%) and it was 7.1% (range: 4.2%-16.8%) in the ND group. During the study conduction 5 new HCV positive cases and 169 new HCV negative cases were added. In the D group, PCR positive patients were dialyzed on dedicated machines. In the ND group all patients shared the same machines.


RESULTS
In the first follow-up period, the incidence of HCV infection was 1.6% and 4.7% in the D and ND group respectively (p = 0.05). In the second follow-up period, the incidence of HCV infection was 1.3% in the D group and 5.7% in the ND group (p < 0.05).


CONCLUSIONS
In this study the incidence of HCV in HD patients decreased by the use of dedicated HD machines for HCV infected patients. Additional studies may help to clarify the role of machine dedication in conjunction with application of universal precautions in reducing HCV transmission.
Shamshirsaz
Alireza Abdollah
AA
Nephrology, Hazrat-e-Rasoul hospital, Tehran, Iran. alirezashamshirsaz@yahoo.com
Kamgar
Mohammad
M
Bekheirnia
Mir Reza
MR
Ayazi
Farzam
F
Hashemi
Seyed Reza
SR
Bouzari
Navid
N
Habibzadeh
Mohammad Reza
MR
Pourzahedgilani
Nima
N
Broumand
Varshasb
V
Shamshirsaz
Amir Hooshang Abdollah
AH
Moradi
Maziyar
M
Borghei
Mehrdad
M
Haghighi
Niloofar Nobakht
NN
Broumand
Behrooz
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003428:Cross Infection / Q000517:prevention & control*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000209:etiology / Q000635:transmission*; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects* / Q000295:instrumentation*; D016635:Universal Precautions / Q000379:methods*