title: Effect of isolation measures on the incidence and prevalence of hepatitis C virus infection in hemodialysis.
abstract: BACKGROUND
  Nosocomial transmission of hepatitis C virus (HCV) in hemodialysis (HD) units is well established. In units with a high prevalence of HCV infection, the implementation of universal precautionary measures may not suffice in order to decrease the incidence and prevalence of HCV. In this setting strict isolation practices can be useful in order to achieve this goal.
  
  
  METHODS
  The incidence and prevalence of HCV infection amongst all HD and peritoneal dialysis (PD) patients from the province of Albacete, Spain, have been studied from 1992 to 2003.Through the 1993-1995 period chronic HD patients were treated either in a room exclusively for HCV- patients or in a room shared by HCV+ and HCV- patients. Complete separation of HCV+ and HCV- patients was implemented in 1995. Acute patients have been separated since 1992. The implementation of universal precautions was applied throughout the period.
  
  
  RESULTS
  There has not been a single seroconversion in the rooms where only HCV- patients were dialyzed during the 11 years of follow-up. There were two seroconversions in the rooms shared for 3 years by both HCV+ and HCV- patients. In 1995 the prevalence of HCV+ cases in HD and PD was 21.6 and 23.2%, respectively. Since then it has decreased steadily and in parallel for both therapies, and the current prevalence is 6.8% in HD and 5.7% in PD.
  
  
  CONCLUSIONS
  In HD units with a high prevalence of HCV+ patients, strict isolation in combination with implementation of universal prevention measures can eliminate nosocomial transmission and obtain a long-term reduction in prevalence.
authors: Servicio de Nefrología, Complejo Hospitalario Universitario de Albacete, Albacete, España. eduardogallego@ono.com
authors: Eduardo
authors: E
authors: Gallego
authors: Aurora
authors: A
authors: López
authors: Juan
authors: J
authors: Pérez
authors: Francisco
authors: F
authors: Llamas
authors: Inmaculada
authors: I
authors: Lorenzo
authors: Esperanza
authors: E
authors: López
authors: Maria Luisa
authors: ML
authors: Illescas
authors: Elena
authors: E
authors: Andrés
authors: Emilio
authors: E
authors: Olivas
authors: Carmen
authors: C
authors: Gómez-Roldan