title: Acute hepatitis C virus infection assessment among chronic hemodialysis patients in the Southwest Parana State, Brazil.
abstract: BACKGROUND
  Chronic hemodialysis patients are at higher risk for acquiring hepatitis C virus (HCV). The prevalence varies among different countries and hemodialysis centers. Although guidelines for a comprehensive infection control program exist, the nosocomial transmission still accounts for the new cases of infection. The aim of this study was analyze the follow up of newly acquired acute hepatitis C cases, during the period from January 2002 to May 2005, in the Hemodialysis Center, located in the Southwest region of Parana State, Brazil and to analyze the effectiveness of the measures to restrain the appearance of new cases of acute hepatitis C.
  
  
  METHODS
  Patients were analyzed monthly with anti-HCV tests and ALT measurements. Patients with ALT elevations were monitored for possible acute hepatitis C.
  
  
  RESULTS
  During this period, 32 new cases were identified with acute hepatitis C virus infection. Blood screening showed variable ALT levels preceding the anti-HCV seroconversion. HCV RNA viremia by PCR analysis was intermittently and even negative in some cases. Ten out of 32 patients received 1 mcg/kg dose of pegylated interferon alfa-2b treatment for 24 weeks. All dialysis personnel were re-trained to strictly follow the regulations and recommendations regarding infection control, proper methods to clean and disinfect equipment were reviewed and HCV-positive patients were isolated.
  
  
  CONCLUSIONS
  Laboratory tests results showed variable ALT preceding anti-HCV seroconversion and intermittent viremia. The applied recommendations contributed importantly to restrain the appearance of new cases of acute hepatitis C in this center and the last case was diagnosed in May 2004.
authors.affiliation: Department of Gastroenterology, Hepatology Branch, University of São Paulo, School of Medicine, São Paulo, Brazil. engel@superig.com.br <engel@superig.com.br>
authors.forename: Maricea
authors.initials: M
authors.lastname: Engel
authors.forename: Fernanda M
authors.initials: FM
authors.lastname: Malta
authors.forename: Michele M S
authors.initials: MM
authors.lastname: Gomes
authors.forename: Isabel M V G C
authors.initials: IM
authors.lastname: Mello
authors.forename: João R R
authors.initials: JR
authors.lastname: Pinho
authors.forename: Suzane K
authors.initials: SK
authors.lastname: Ono-Nita
authors.forename: Flair J
authors.initials: FJ
authors.lastname: Carrilho
mesh_terms: D000208:Acute Disease; D001938:Brazil / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology / Q000821:virology; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D006436:Hemodialysis Units, Hospital / Q000706:statistics & numerical data; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000097:blood* / Q000453:epidemiology / Q000235:genetics / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D010356:Patient Isolation / Q000379:methods; D006435:Renal Dialysis / Q000009:adverse effects*; D012698:Serologic Tests; D016635:Universal Precautions; D014766:Viremia / Q000235:genetics