الفهرس 
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Abstract
The relation between HCV infection and kidney disorders is well recognized. On one hand, hepatitis C infection has been associated with essential mixed cryoglobulinemia that may lead to membranoproliferative glomerulonephritis , but on the other hand, patients with renal disease are at an increased risk of acquiring HCV because of prolonged vascular access and the potential
for exposure to infected patients and contaminated equipment.
Hepatitis C virus (HCV) prevalence differs among hemodialysis units according to their geographical location, health care procedures, socioeconomic factors, reuse of lines, hygiene and sterilization of equipment, patient rotation of machines and the undertaking of rigorous universal precaution rules. These features influence the risk of nosocomial transmission of HCV to hemodialysis patients.
The prevalence of hepatitis C virus (HCV) infection is estimated to be 3% worldwide, Egypt has the largest epidemic of hepatitis C virus (HCV) in the world with 14.7% of the population are infected with HCV.
The prevalence of anti-HCV positivity among dialysis patients varies in different countries (5%-85% worldwide), but may exceed 95% in some HD units.
This work is a part of project aiming at making survey about HCV, assessment its prevalence, its seroconversion and study risk factors associated with HCV seroconversion among all hemodialysis patients in Egypt. This project is modulated by Nephrology department, Ain Shams university.
Our study was conducted on all patients on regular hemodialysis sessions attending different hemodialysis centers in West area of Cairo governorate (sector D) which includes El Mosky area, El Waily area, Boulak area, Abdeen area ,Bab El sharea area ,El Zamalek, Kasr El Nile area, El Gamalia, El Darb Elahmar area and Mansheat Naser area In this multicenter study, we sought to investigate the prevalence of HCV infection among all hemodialysis patients in WEST area of Cairo governorate (sector D), to include an estimation of the anti-HCV seroprevalence and to delineate events and factors associated with HCV seroconversion.
All patients in the work were evaluated using questionnaire form for assessment of risk factors causing HCV infection in hemodialysis patients such as; Age, Sex, Duration of hemodialysis , Previous blood transfusion, Previous surgery, Isolation procedures in the centers, Dialysis in other centers, Vascular access used, History of Shistosomiasis, History of HBs Ag, Family history of hepatitis and Causes of chronic kidney disease.
It was found that:
HCV infected patients were 49.2 %, HBV infected patients were 2.2%, Combined HCV and HBV were 2.02%. HCV antibodies free were 50.8 % while the HCV seroconvertion rate was 42.7%.
Out of the 545 patients 65.0 % were males and 35.0 % were females and the mean age was 14.7±0.7 years .
The most common etiology of renal failure was hypertention (44.2%) .
Statistical significant association was found between HCV and previous blood transfusion, infection with HBV Ag, dialyzing in more than one center , the 2nd vascular access , application of infection control measures and the present of isolation procedures . it was found that the percentage of convertion was higher on isolation by machines than by place.
Consequently, nosocomial practices seem to be the predominant mechanism of HCV transmission in the HD setting and isolation of HCV-infected patients is not recommended as an alternative to strict infection-control procedures for preventing transmission of blood-borne pathogens.
In the present study, there was no relationship between conversion to HCV positive state and previous surgeries done, age, sex, 1st vascular access and family history of hepatitis or previous history of Bilharziasis.