Methods used to reduce the prevalence of hepatitis C in a dialysis unit.

In the present study, we report on the follow-up of the epidemiology of hepatitis C viremia in our dialysis unit after our previous report, over the period from July 1, 2003 to December 31, 2005. The methods to reduce the prevalence of hepatitis C viremia in our center included: strict adherence to universal infection control precautions, separation of hepatitis C virus (HCV) positive patients from the negative patients and using specially designated machines for them, and from July 2003, periodic testing of all patients for HCV-RNA. Following the application of the above mentioned methods, we have not had, since 31 December 2005, any case of sero-conversion from HCV-negative to HCV-positive in our dialysis unit and the only HCV-positive patients present were those who were already positive at entry. The overall prevalence of HCV-RNA positive patients in our unit has presently come down to 6.5%. Although isolation and use of designated machines for HCV-RNA positive patients is not recommended following the latest guidelines of "Kidney Disease: Improving Global Outcomes" (KDIGO, 2008), the present study supports previous reports that these measures might be beneficial, when there is a high prevalence of HCV-RNA positive patients, and in units where due to understaffing or other causes, break in infection control procedures is likely to occur.