High prevalence of hepatitis C infection among patients receiving hemodialysis at an urban dialysis center Journal Article

Authors: Sivapalasingam, S.; Malak, S. F.; Sullivan, J. F.; Lorch, J.; Sepkowitz, K. A.
Article Title: High prevalence of hepatitis C infection among patients receiving hemodialysis at an urban dialysis center
Abstract: OBJECTIVE: To determine the seroprevalence and risk factors for hepatitis C virus (HCV) infection among patients at an urban outpatient hemodialysis center. METHODS: This was a cross-sectional study of 227 patients undergoing hemodialysis at the Rogosin Kidney Center on December 15, 1998, with a response rate of 90% (227 of 253). Laboratory records were used to retrieve the total number of blood transfusions received and serologic study results. Univariate and multivariate analyses were used to examine the relationship among HCV serostatus, patient demographics, and HCV risk factors (eg, intravenous drug use [IVDU], intranasal cocaine use, multiple sexual partners, comorbidities, length of time receiving hemodialysis, and total number of blood transfusions received). RESULTS: The seroprevalence of antibody to HCV (anti-HCV) was 23.3% (53 of 227) in the population. In univariate analysis, factors associated with HCV seropositivity included male gender, younger age, history of IVDU, history of intranasal cocaine use, history of multiple sexual partners, human immunodeficiency virus coinfection, increased time receiving dialysis, history of renal transplant, and positive antibody to hepatitis B core antigen. Multivariate logistic regression analysis showed that longer duration receiving dialysis and a history of IVDU were the only risk factors that remained independently associated with HCV seropositivity. CONCLUSIONS: HCV is markedly more common in our urban cohort of patients receiving hemodialysis compared with patients receiving dialysis nationally and is associated with a longer duration of receiving dialysis and a history of IVDU. Stricter and more frequent enforcement of universal precautions may be required in hemodialysis centers located in areas with a high prevalence of HCV infection or IVDU among the general population.
Keywords: adult; controlled study; aged; middle aged; major clinical study; hepatitis c; united states; human immunodeficiency virus infection; risk factors; risk factor; risk assessment; blood; immunology; medical record; comorbidity; blood transfusion; multivariate analysis; epidemiology; hepatitis c virus; hepacivirus; new york; logistic regression analysis; hemodialysis; sexual behavior; disease transmission; urban population; middle age; renal dialysis; intravenous drug abuse; seroprevalence; seroepidemiologic studies; renal replacement therapy; cocaine dependence; humans; human; male; female; article; hepatitis b core antibody; hepatitis b core antigen; hepatitis c antibody; hepatitis c antibodies
Journal Title: Infection Control and Hospital Epidemiology
Volume: 23
Issue: 6
ISSN: 0899-823X
Publisher: The Society for Healthcare Epidemiology of America  
Date Published: 2002-06-01
Start Page: 319
End Page: 324
Language: English
PUBMED: 12083235
PROVIDER: scopus
DOI: 10.1086/502058
Notes: Export Date: 14 November 2014 -- Source: Scopus
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MSK Authors
  1. Kent A Sepkowitz
    247 Sepkowitz
  2. Sharp Malak
    13 Malak