Hepatitis C Virus Infection and HCV Genotypes of Hemodialysis Patients

To evaluate the prevalence of hepatitis C by antibody testing, HCV-RNA detection by PCR and relative risk fac tors of HCV infection among HD patients and staff members in Markazi Province/Iran. The other purpose was to deter mine genotypes of HCV in this population. The study group consisted of 204 HD patients and 47 staff members from all 9 dialysis centers in Markazi Prov ince, Iran. Anti-HCV antibodies were tested using a third generation ELISA and confirmed by RIBA. HCV RNA was deter mined by RT-PCR and genotyping was performed by a reverse hybridization assay (LiPA). The overall prevalence of HCV (HCV antibody and HCV-RNA) was 5.4%. Female sex (P= 0.019), duration of dialy sis (P= 0.003) and kidney transplant (P= 0.049) were significantly correlated with HCV infection. The predominant sub type was HCV-1a, detected in 4(50%) of the 8 HD patients. Genotype 4, 3a and 1b were found in 2(25%), 1(12.5%) and 1(12.5%) patients respectively. The prevalence of anti-HCV among staff members of HD units was 0%. The presence of anti HCV positive patients who had never been transfused, high prevalence of genotype 4 in this population, duration of HD as a risk factor for HCV positivity and non significant association between blood transfu sion and HCV infection suggest nosocomial transmission of the virus in dialysis units that needs to be confirmed by phyloge netic analysis of subgenomic regions of HCV. HD staff members dose not seem to be at increased risk of hepatitis C de spite the frequent blood exposure and lack of strict adherence to universal infection control precautions.