Decrease in the hepatitis C virus (HCV) prevalence in hemodialysis patients in Spain: effect of time, initiating HCV prevalence studies and adoption of isolation measures.

The effectiveness of isolation measures to prevent hepatitis C virus (HCV) infection in hemodialysis units is a controversial issue. Strict adherence to the universal infection control precautions has been deemed adequate to prevent nosocomial transmission of HCV. Subsequently, however, select isolation measures, such as the clustering of HCV positive patients in a defined sector of the unit, have been adopted, specially for those units with a high HCV prevalence and when the personnel-patient ratio was such that it could involuntary favor the break of the universal precautions. In this Multicenter Spanish Study on HCV in Dialysis, the importance of both time and isolation measures led to a decrease of HCV prevalence. Time was the most important factor (although interacting with the isolation measures) and was independent of the initial HCV prevalence.