"Study of risk factors about HCV transmission in Spanish Hemodialysis (HD) units"

Barril G, Traver Sanz P on behalf "Spanish work Group HCV on Dialysis"

Madrid. ESPAÑA

Aim and Methods: We analysed the risk factors implied in the seroconversions happened in the HD patients concern of "Spanish multicenter study to the HCV in Dialysis, where we recall information from 138 seroconversions SC happened during 4 years (1996-1999).

It's compared, as control, with two patients HCV negatives from the same unit. Is collected antecedents 6 months previous of raises aminotransferases, transfusions, surgery, central vein catheterization, risk outpatient, (DAVP)and tattoo, living together with other HCV + person.

In case to be a centre with isolation measures we evaluated if is dialysed next to a HCV+ patients and in some moment could have not been adequate isolate.
Seroconversions HCV Neg. Controls p
Mean age (years) 61,4 years 62,2 years p.n.s
Gender (% F/M) 39% - 61% 41% - 59% p.n.s
Mean months HD 40,6 months 41,9 months p.n.s
% increase aminotransf 65,1% 6% 0,00000

Rise of aminotransferases level appear as a good predictor from the possible SC, therefore the periodic monitorization selframe must be binding obliged.
Transfusión 1,62 (0,99 - 2,65) 0,042
Surgery 1,27 (0,78 -2,09) p.n.s
Catheterization 1,93 (1,12 - 3,31) 0,01
Risk outpatient 1,17 (0,61 -2,22) p.n.s
HCV+ relative 5,23 (0,97 - 37,27) 0,02
Next to HCV+ monitor 1,33 (0,7 - 2,3) p.n.s
Contact with HCV+monitor 2,94 (1,35 - 6,42) 0,002


Although with small OR appear as risk factor the central vein catheterisation and transfusion there is to detail that 29% of the sample present transfusion antecedent. Hardly is had communicated case of DAVP neither tatoo. We find a HCV+ big adding in the families of patients seroconverted.

We find a significant correlation in every year of the study between SC and the centre prevalence, showing the centres with a number higher than 3SC the highest prevalence.

We didn't find in our study, higher risk in the patients dialysed next to HCV+ monitor, so the factor nursery as horizontal transmission of the HCV, must beat in mind , and insist in the importance to and extreme the Universal Precaution, overall in centres with high prevalence.

In centres that refer a isolation politic to the HCV ,we find a high percentage of wrong isolations in SC group, been the mouve most referred to the acute unit the most referred