title: Incidence of hepatitis c virus seroconversion among hemodialysis patients in the Nile Delta of Egypt: A single-center study.
abstract: Egypt has the highest worldwide prevalence of hepatitis C virus (HCV) infection, caused in part by nosocomial transmission. Patients on hemodialysis (HD) are at especially high risk of infection. We aimed to estimate the incidence of seroconversion among HCV-negative patients undergoing regular HD at a unit in a large public hospital in the Nile Delta of Egypt, which implements the Egyptian Ministry of Health guidelines for infection control, and an isolation policy for hepatitis-positive patients. We also assessed the adherence to infection control practices and evaluated nurses and physicians' knowledge and attitude toward infection control procedures. Records of HCV-negative patients undergoing regular HD at the unit from August 2008 to August 2010 were reviewed retrospectively for data on HCV status. Patients were then followed up until September 2011, when polymerase chain reaction was performed for all patients. Infection control practices were evaluated by four checklists applied monthly and analyzed by control charts. Nurses and physicians' knowledge and attitudes toward infection control were assessed by interview questionnaires. Of 60 patients followed up, there was one case of HCV seroconversion giving an incidence rate of 0.676/100 person-years of follow-up (95% confidence interval: 0.017-3.76). There were no cases of hepatitis B virus seroconversion. The mean scores of all the infection control practices' checklists were very high and generally remained above the lower control limit over the 12-month period. Physicians and nurses achieved very high scores on knowledge and attitude on infection control (mean score >95%). This public facility had a low seroconversion rate and high adherence to infection control guidelines.
authors.affiliation: Department of Internal Medicine, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Amany Talaat
authors.initials: AT
authors.lastname: Kamal
authors.affiliation: Department of Internal Medicine, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed Nazmy
authors.initials: MN
authors.lastname: Farres
authors.affiliation: Department of Internal Medicine, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Abeer Mohamed
authors.initials: AM
authors.lastname: Eissa
authors.affiliation: Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Naglaa Ahmed
authors.initials: NA
authors.lastname: Arafa
authors.affiliation: Damanhour Medical National Institute, Damanhour, Beheira Governorate, Egypt.
authors.forename: Raafat Saad
authors.initials: RS
authors.lastname: Abdel-Reheem
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D057189:Checklist; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D004534:Egypt / Q000453:epidemiology; D005260:Female; D016174:Hepacivirus / Q000276:immunology*; D006526:Hepatitis C / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D000069078:Seroconversion; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D018937:Hepatitis C Antibodies