Quality control measures for lowering the seroconversion rate of hemodialysis patients with hepatitis B or C virus.
BACKGROUND
Hemodialysis (HD) patients are at high risk of infection by hepatitis B virus (HBV) or hepatitis C virus (HCV). The present study was designed to determine the impact of quality control measures on the prevention of transmission of blood-borne viruses.


METHODS
A total of 6182 adult maintenance HD patients from all HD units in Zhejiang Province were recruited on January 1, 2007. The baseline demographic and clinical characteristics were recorded and all patients were followed up until death or survival at 4 years later. The Quality Control Standards of Hemodialysis were gradually implemented in HD units. The HBV or HCV seroconversion rates of the recruited patients were calculated and compared every year during the observation period.


RESULTS
The prevalence of HBV was 8.3% at the beginning of the study, and 6.6% for HCV. With the implementation of the HD quality control measures, the HBV seroconversion rate tended to decrease year by year (X2=6.620, P=0.085), and the HCV seroconversion rate decreased significantly (X2=10.41, P=0.015). Compared with the data in 2007, the HBV seroconversion rate (X2=4.204, P=0.040, relative risk ratio 0.393, 95% CI 0.156-0.991) and the HCV seroconversion rate (X2=7.373, P=0.007, relative risk ratio 0.386, 95% CI 0.189-0.787) decreased significantly in 2010.


CONCLUSIONS
Quality control measures for HD decreased the seroconversion rates of HBV or HCV in HD patients, showing that updated quality control measures reduce the risk for transmission of blood-borne viruses in the HD population.
Zhejiang University School of Medicine, Hangzhou, China.
Jing
J
Yuan
Yi
Y
Yang
Fei
F
Han
Ping
P
Zhang
Xiao-Ying
XY
Du
Hua
H
Jiang
Jiang-Hua
JH
Chen
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D005260:Female; D019983:Guideline Adherence; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D017053:Infection Control / Q000592:standards*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011786:Quality Control; D019984:Quality Indicators, Health Care / Q000592:standards*; D006435:Renal Dialysis / Q000009:adverse effects / Q000592:standards*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors