Infectious hepatitis in dialysis patients.

Infectious hepatitis is a major problem for patients with end-stage renal disease and for staff caring for these patients. Initially hepatitis B was the major cause of hepatitis in dialysis patients and staff. Patients had a tendency to develop chronic hepatitis or become chronic carriers of the virus while staff either developed typical acute hepatitis or a primary antibody response. The discovery of the hepatitis B surface antigen (HBsAg), the screening of transfused blood for HBsAg, and the institution of infection control measures including isolation techniques have resulted in a remarkable decrease in the incidence of this disease. Nonetheless, the problem of infectious hepatitis continues as non-A, non-B hepatitis has become more commonplace among dialysis patients. Unfortunately, no viral markers have been discovered, and blood products remain the major vehicle of transmission. The institution of infection control measures similar to those used to control hepatitis B has probably been effective in controlling the spread of this disease. It is hoped that the discovery of the etiologic agent(s), with the eventual goal of screening blood products and the development of a vaccine, will lead to full control of this disorder.