Hepatitis C infection and the risk of bacteremia in hemodialysis patients with tunneled vascular access catheters.
BACKGROUND
The major complication of tunneled vascular catheters in dialysis patients is infection. In preliminary work, an association was noted between hepatitis C virus (HCV) infection and bacteremia in these patients. On this basis, we theorized that HCV infection may be associated with bacteremia in dialysis patients with tunneled catheters.


METHODS
We conducted a two-phase clinical study to define the association between HCV infection and bacteremia in hemodialysis patients with catheters. Phase 1 was a cross-sectional study designed to assess the association between HCV serologic status and bacteremia. Phase 2 was a prospective study that examined the relationship between HCV viral load and bacteremia.


RESULTS
In Phase 1, HCV (+) patients had a significantly greater prevalence of bacteremia than HCV (-) patients (61 vs 7.7% respectively, P < 0.05). In Phase 2, the presence of detectable virus was associated with a numerical trend toward an increase in the incidence of bacteremia (40 vs 0% for patients with and without detectable virus, respectively, P = 0.09).


CONCLUSIONS
These studies suggest that HCV infection may be associated with the development of bacteremia in hemodialysis patients with tunneled catheters.
Reddy
Shilpa
S
Department of Medicine, University of Florida College of Medicine Jacksonville, Jacksonville, FL 32259, USA. shilpa.reddy@jax.ufl.edu
Sullivan
Robert
R
Zaiden
Robert
R
De Mendoza
Victor Lopez
VL
Naik
Nimish
N
Vega
Kenneth J
KJ
Nahman
N Stanley
NS
Alexandraki
Irene
I
D000704:Analysis of Variance; D016470:Bacteremia / Q000453:epidemiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D005431:Florida / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D019562:Viral Load