Transmission of the hepatitis C virus in an hemodialysis unit : evidence for nosocomial infection.
Hepatitis C virus (HCV) infection is a frequent feature in hemodialysis (HD) patients.
The way of viral transmission is difficult to establish, but in previous studies the role of blood transfusions and of HD treatment duration, and the possibility of nosocomial transmission of the virus have been suggested.
We present here the results of a virological follow-up of HCV infection in our HD unit in 1993-1994, and a molecular study of viral strains that led to a possible reconstruction of viral spreading.
All patients in our unit were regularly tested for alanine aminotransferase, HCV antibodies and HCV RNA in serum.
Seven seroconversions were detected during follow-up, and a high proportion of type lb HCV strains was found in infected patients.
Nucleotide sequences located in the envelope I (El) viral coding region of type lb strains were compared in our patients and numerous controls infected with the same HCV genotype.
A high proportion of patients with antibodies to HCV were detected in our unit (32.5%). Blood transfusions and duration of HD treatment were risk factors for HCV infection.
Seroconversions in patients never transfused and predominance of type 1b HCV strains suggested that infection had occurred via the nosocomial pathway in our unit.
Similar sequences in the El region were found in four patients treated, forming a distinct cluster in a phylogenetic tree. (...)
Mots-clés Pascal : Insuffisance rénale, Chronique, Hémodialyse, Séropositivité, Virus hépatite C, Flaviviridae, Virus, Infection nosocomiale, France, Europe, Traitement, Complication, Homme, Appareil urinaire pathologie, Rein pathologie, Epuration extrarénale, Immunopathologie
Mots-clés Pascal anglais : Renal failure, Chronic, Hemodialysis, Seropositivity, Hepatitis C virus, Flaviviridae, Virus, Nosocomial infection, France, Europe, Treatment, Complication, Human, Urinary system disease, Kidney disease, Extrarenal dialysis, Immunopathology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0257276
Code Inist : 002B27B03. Création : 11/06/1997.