BACKGROUND: Hepatitis C virus (HCV) outbreaks among patients on hemodialysis are still an important health concern all over the world. AIMS: We performed a systematic review of reports on HCV outbreaks within dialysis units of developed and less-developed countries (between 1992 and 2015) to evaluate risk factors and practices associated with patient-to-patient transmission of HCV in this setting. METHODS: The research was performed using the PubMed Database and the Outbreak Database; studies were selected according to the PRISMA algorithm. Inclusion criteria were established before the papers were retrieved in order to avoid selection biases. RESULTS: 36 papers reported on 45 outbreaks that involved 335 unique patients on maintenance hemodialysis; no fatal cases were detected. Nosocomial transmission of HCV was confirmed by phylogenetic analysis in most (n=31; 69%) reports. Sharing contaminated hemodialysis machines and multidose vials (heparin or saline solution) was suggested responsible for HCV transmission in 8 (18%) and 6 (13%) outbreaks, respectively. Breaches in environmental cleaning and disinfection practices, and failures in medication preparation and administration practices was considered in 29 (65%) outbreaks; however, the exact mechanism of transmission of HCV could not be ascertained in each facility where an outbreak occurred. CONCLUSIONS: Our systematic review of reports on hepatitis C virus outbreaks shows that, although the full extent of HCV transmission in dialysis units is unknown, outbreaks continue to occur. Full compliance to standard/specific infection control procedures and routine serologic screening for HCV antibody play a pivotal role for preventing the transmission of HCV within hemodialysis units.
BACKGROUND:Hepatitis C virus (HCV) outbreaks among patients on hemodialysis are still an important health concern all over the world. AIMS: We performed a systematic review of reports on HCV outbreaks within dialysis units of developed and less-developed countries (between 1992 and 2015) to evaluate risk factors and practices associated with patient-to-patient transmission of HCV in this setting. METHODS: The research was performed using the PubMed Database and the Outbreak Database; studies were selected according to the PRISMA algorithm. Inclusion criteria were established before the papers were retrieved in order to avoid selection biases. RESULTS: 36 papers reported on 45 outbreaks that involved 335 unique patients on maintenance hemodialysis; no fatal cases were detected. Nosocomial transmission of HCV was confirmed by phylogenetic analysis in most (n=31; 69%) reports. Sharing contaminated hemodialysis machines and multidose vials (heparin or saline solution) was suggested responsible for HCV transmission in 8 (18%) and 6 (13%) outbreaks, respectively. Breaches in environmental cleaning and disinfection practices, and failures in medication preparation and administration practices was considered in 29 (65%) outbreaks; however, the exact mechanism of transmission of HCV could not be ascertained in each facility where an outbreak occurred. CONCLUSIONS: Our systematic review of reports on hepatitis C virus outbreaks shows that, although the full extent of HCV transmission in dialysis units is unknown, outbreaks continue to occur. Full compliance to standard/specific infection control procedures and routine serologic screening for HCV antibody play a pivotal role for preventing the transmission of HCV within hemodialysis units.
Authors: Liangying Gan; Dongyu Wang; Brian Bieber; Keith McCullough; Michel Jadoul; Ronald L Pisoni; Fanfan Hou; Xinling Liang; Zhaohui Ni; Xiaonong Chen; Yuqing Chen; Li Zuo Journal: Front Med (Lausanne) Date: 2022-06-15
Authors: Roberto Minutolo; Alessio Aghemo; Antonio Chirianni; Fabrizio Fabrizi; Loreto Gesualdo; Edoardo G Giannini; Paolo Maggi; Vincenzo Montinaro; Ernesto Paoletti; Marcello Persico; Francesco Perticone; Salvatore Petta; Massimo Puoti; Giovanni Raimondo; Maria Rendina; Anna Linda Zignego Journal: Intern Emerg Med Date: 2018-09-25 Impact factor: 3.397
Authors: Arun Rajasekaran; Ricardo A Franco; Edgar T Overton; Brendan M McGuire; Graham C Towns; Jayme E Locke; Deirdre L Sawinski; Emmy K Bell Journal: Kidney Int Rep Date: 2021-04-25
Authors: Rilma F S Santos; Gildásio C Conceição; Márcia S Martins; Angiolina Kraychete; Maria A C Penalva; Edgar M Carvalho; Antonio Alberto Lopes; Paulo Novis Rocha Journal: BMC Nephrol Date: 2017-02-15 Impact factor: 2.388