title: Evidence of association between hepatitis C virus genotype 2b and nosocomial transmissions in hemodialysis centers from southern Brazil.
abstract: BACKGROUND
  Hepatitis C virus infection is a serious public health problem. Hemodialysis is considered one of the main risk factors of HCV infection, due to several invasive medical procedures and potential nosocomial transmission that patients with chronic renal failure (CRF) are continuously submitted. The aims of this study were to determine the prevalence of HCV and its genotypes in patients with CRF in hemodialysis units in southern Brazil.
  
  
  METHODS
  Demographic data and risk factors for HCV transmission were collected and analyzed. These data were obtained from patients undergoing hemodialysis treatment from January 2009 to August 2010, on two dialysis units of Rio Grande, southern Brazil. Genotyping was carried out by sequencing analysis of HCV NS5b, core-E1 junction and 5'UTR genomic regions.
  
  
  RESULTS
  One hundred fifty-nine patients under regular hemodialysis treatment were studied. HCV prevalence was 23.3%. HCV-infected patients had been on dialysis treatment for 91.9 months, a more prolonged period compared to HCV-negative patients (p = 0.001). While HCV genotypes 1b and 3a were identified as the most frequent strains, a surprisingly high proportion of genotype 2b was observed among patients in one of the dialysis centers compared to the general HCV-infected population of the same area. Hemodialysis treatment exposure time and healthcare working were associated with HCV infection.
  
  
  CONCLUSIONS
  Besides the efforts to minimize nosocomial transmission of HCV, some events of transmission are still evidenced in dialysis units.
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Brazil.
authors.forename: Naylê Maria Oliveira
authors.initials: NM
authors.lastname: da Silva
authors.forename: Fabiana Nunes
authors.initials: FN
authors.lastname: Germano
authors.forename: Raul Andres
authors.initials: RA
authors.lastname: Mendoza-Sassi
authors.forename: Hector Nicolas
authors.initials: HN
authors.lastname: Seuánez
authors.forename: Marcelo Alves
authors.initials: MA
authors.lastname: Soares
authors.forename: Ana Maria Barral
authors.initials: AM
authors.lastname: de Martinez
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000635:transmission / Q000821:virology*; D005260:Female; D005838:Genotype; D006436:Hemodialysis Units, Hospital; D016174:Hepacivirus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D015995:Prevalence; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors