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High Prevalence of Hepatitis C Infection Among Patients Receiving Hemodialysis at an Urban Dialysis Center

Published online by Cambridge University Press:  02 January 2015

Sumathi Sivapalasingam ,
Sharp F. Malak ,
John F. Sullivan ,
Jonathan Lorch  and
Kent A. Sepkowitz
Sumathi Sivapalasingam
Affiliation:
Department of Medicine, New York Presbyterian Hospital, Cornell Campus, New York, New York
Sharp F. Malak
Affiliation:
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
John F. Sullivan
Affiliation:
Department of Medicine, New York Presbyterian Hospital, Cornell Campus, New York, New York
Jonathan Lorch
Affiliation:
Department of Medicine, New York Presbyterian Hospital, Cornell Campus, New York, New York
Kent A. Sepkowitz*
Affiliation:
Department of Medicine, New York Presbyterian Hospital, Cornell Campus, New York, New York Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
*
Clinical Infectious Disease Section, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Box 288, New York, NY 10021
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Abstract

Objective:

To determine the seroprevalence and risk factors for hepatitis C virus (HCV) infection among patients at an urban outpatient hemodialysis center.

Methods:

This was a cross-sectional study of 227 patients undergoing hemodialysis at the Rogosin Kidney Center on December 15, 1998, with a response rate of 90% (227 of 253). Laboratory records were used to retrieve the total number of blood transfusions received and serologic study results. Univariate and multivariate analyses were used to examine the relationship among HCV serostatus, patient demographics, and HCV risk factors (eg, intravenous drug use [IVDU], intranasal cocaine use, multiple sexual partners, comorbidities, length of time receiving hemodialysis, and total number of blood transfusions received).

Results:

The seroprevalence of antibody to HCV (anti-HCV) was 23.3% (53 of 227) in the population. In univariate analysis, factors associated with HCV seropositivity included male gender, younger age, history of IVDU, history of intranasal cocaine use, history of multiple sexual partners, human immunodeficiency virus coinfection, increased time receiving dialysis, history of renal transplant, and positive antibody to hepatitis B core antigen. Multivariate logistic regression analysis showed that longer duration receiving dialysis and a history of IVDU were the only risk factors that remained independently associated with HCV seropositivity.

Conclusions:

HCV is markedly more common in our urban cohort of patients receiving hemodialysis compared with patients receiving dialysis nationally and is associated with a longer duration of receiving dialysis and a history of IVDU. Stricter and more frequent enforcement of universal precautions may be required in hemodialysis centers located in areas with a high prevalence of HCV infection or IVDU among the general population.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 6 , June 2002 , pp. 319 - 324
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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