Background: Nosocomial transmission of hepatitis C virus (HCV) in hemodialysis (HD) units is well established. In units with a high prevalence of HCV infection, the implementation of universal precautionary measures may not suffice in order to decrease the incidence and prevalence of HCV. In this setting strict isolation practices can be useful in order to achieve this goal. Methods: The incidence and prevalence of HCV infection amongst all HD and peritoneal dialysis (PD) patients from the province of Albacete, Spain, have been studied from 1992 to 2003.Through the 1993–1995 period chronic HD patients were treated either in a room exclusively for HCV– patients or in a room shared by HCV+ and HCV– patients. Complete separation of HCV+ and HCV– patients was implemented in 1995. Acute patients have been separated since 1992. The implementation of universal precautions was applied throughout the period. Results: There has not been a single seroconversion in the rooms where only HCV– patients were dialyzed during the 11 years of follow-up. There were two seroconversions in the rooms shared for 3 years by both HCV+ and HCV– patients. In 1995 the prevalence of HCV+ cases in HD and PD was 21.6 and 23.2%, respectively. Since then it has decreased steadily and in parallel for both therapies, and the current prevalence is 6.8% in HD and 5.7% in PD. Conclusions: In HD units with a high prevalence of HCV+ patients, strict isolation in combination with implementation of universal prevention measures can eliminate nosocomial transmission and obtain a long-term reduction in prevalence.

1.
Stehman-Breen CO, Emerson S, Gretch D, Jonson RJ: Risk of death among chronic dialysis patients infected with hepatitis C virus. Am J Kidney Dis 1998;32:629–634.
2.
Pereira BJG, Navot SN, Bouthot BA, Murthy BVR, Rhutazer R, Schmid CH, Levey AS: Effect of hepatitis C infection and renal transplantation on survival in end-stage renal disease. Kidney Int 1998;53:1374–1381.
3.
Gentil MA, Rocha JL, Rodríguez-Algarra G, Periera P, López R, Bernal G, Muñoz J, Naranjo M, Mateos J: Impaired kidney transplant survival in patients with antibodies to hepatitis C. Nephrol Dial Transplant 1999;14:2455–2460.
4.
Pereira BJG, Levey AS: Hepatitis C virus infection in dialysis and renal transplantation. Kidney Int 1997;51:981–999.
5.
Okuda K, Hayashi H, Kobayashi S, Irie Y: Mode of hepatitis C infection not associated with blood transfusion among chronic haemodialysis patients. J Hepatol 1995;23:28–31.
6.
McLaughlin K, Cameron S, Good T, McCruden E, Ferguson J, Davidson F, Simmonds P, Mactier R, McMillan M: Nosocomial transmission of hepatitis C virus within a British dialysis centre. Nephrol Dial Transplant 1997;12:304–309.
7.
Pereira BJG: Hepatitis C in dialysis. Semin Dial 1998;11:113–118.
8.
Gilli P, Soffritti S, Vitali DP, Bedani PL: Prevention of hepatitis C virus in dialysis units. Nephron 1995;70:301–306.
9.
Jadoul M, Cornu C, van Ypersele de Strihou C, and the Universitaires Cliniques St-Luc (UCL) Collaborative Group: Universal precautions prevent hepatitis C virus transmission: a 54 month follow-up of the Belgian multicenter study. Kidney Int 1998;53:1022– 1025.
10.
Center for Disease Control and Prevention: Recommendations for preventing transmission of infection among chronic haemodialysis patients. MMWR Recomm Rep 2001;50:1–43.
11.
Teruel JL: ¿Hay que utilizar salas de hemodiálisis separadas para los enfermos HVC? Una opinión personal. Nefrología 2002;22:13–14.
12.
Blumberg A, Zeder C, Burckhardt JJ: Prevention of hepatitis C infection in haemodialysis units. A prospective study. Nephrol Dial Transplant 1995;10:230–233.
13.
Alcázar R, Ferreras I, Castell J, González JC, Echevarria JM, De la Torre M, Sánchez de la Nieta MD, Nieto J, Caparrós G, Rivera F: Brote de infección por el virus C de la hepatitis (VHC) en una unidad de diálisis hospitalaria. Nefrología 2002;22(suppl 6):61.
14.
Meyers CM, Seeff LB, Stehman-Breen CO, Hoofnagle JH: Hepatitis C and renal disease: an update. Am J Kidney Dis 2003;42:631–657.
15.
Dos Santos JP, Loureiro A, Cendoroglo Neto M, Pereira BJ: Impact of dialysis room and reuse strategies on the incidence of hepatitis C virus infection in haemodialysis units. Nephrol Dial Transplant 1996;11:2017–2022.
16.
Arenas MD, Gonzalez C, Enriquez R, Cabezuelo JB, Lacueva J, Antolín A, Reyes A: Eficacia del aislamiento de pacientes anti-VHC positivos en hemodiálisis. Nefrología 1995;15:141–147.
17.
Nachtigal J, Modena F, Cazzador S, Grando R, Antonucci F, Cappellato MG: Prevention of hepatitis C virus infection in a haemodialysis centre. Nephrol Dial Transplant 1996;11:1490–1491.
18.
Djordjevic V, Stojanovic K, Stojanovic M, Stefanovic V: Prevention of nosocomial transmission of hepatitis C infection in a haemodialysis unit. A prospective study. Int J Artif Organs 2000;23:181–188.
19.
Saxena AK, Panhotra BR, Sundaram DS, Naguib M, Venkateshappa CK, Uzzaman W, Mulhim KA: Impact of dedicated space, dialysis equipment, and nursing staff on the transmission of hepatitis C virus in haemodialysis unit of the middle east. Am J Infect Control 2003;31:26–33.
20.
Petrosillo N, Gilli P, Serraino D, Dentico P, Mele A, Ragni P, Puro V, Casalino C, Ippolito G: Prevalence of infected patients and understaffing have a role in hepatitis C virus transmission in dialysis. Am J Kidney Dis 2001;37:1004–1010.
21.
Jadoul M, Poignet JL, Geddes C, Locatelli F, Medin C, Krajewska M, Barril G, Scheuermann E, Sonkodi S, Goubau P: The changing epidemiology of hepatitis C virus (HCV) infection in haemodialysis: European multicentre study. Nephrol Dial Transplant 2004;19:904–909.
22.
Ojo AO, Held PJ, Port FK, Wolfe RA, Leichtman AB, Young EW, Arndorfer J, Christensen L, Merion RM: Chronic renal failure after transplantation of a nonrenal organ. N Engl J Med 2003;349:931–940.
23.
Barril G, González Parra E, Alcázar R, Arenas D, Campistol JMª, Caramelo C, Carrasco M, Carreño V, Espinosa M, García Valdecasas J, Górriz JL, López MªD, Martín L, Ruiz P, Teruel JL: Guías sobre enfermedades víricas en hemodiálisis. Nefrología 2004;24(suppl 2):43–66.
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