title: Hepatitis C infection and the risk of bacteremia in hemodialysis patients with tunneled vascular access catheters.
abstract: 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.
authors.affiliation: Department of Medicine, University of Florida College of Medicine Jacksonville, Jacksonville, FL 32259, USA. shilpa.reddy@jax.ufl.edu
authors.forename: Shilpa
authors.initials: S
authors.lastname: Reddy
authors.forename: Robert
authors.initials: R
authors.lastname: Sullivan
authors.forename: Robert
authors.initials: R
authors.lastname: Zaiden
authors.forename: Victor Lopez
authors.initials: VL
authors.lastname: De Mendoza
authors.forename: Nimish
authors.initials: N
authors.lastname: Naik
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Vega
authors.forename: N Stanley
authors.initials: NS
authors.lastname: Nahman
authors.forename: Irene
authors.initials: I
authors.lastname: Alexandraki
mesh_terms: 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