الفهرس | Only 14 pages are availabe for public view |
Abstract Hepatitis C is the most common liver disease in renal dialysis patients while liver disease itself is a significant cause of morbidity and mortality in patients with end-stage renal disease (ESRD) treated by dialysis or transplantation. ••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. ••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 EL Menofia governorate sector (A) which includes Shebin EL Kome city, Menof city, El Bagor city and Sers El Lian city. ••In this multicenter study, we sought to investigate the prevalence of HCV infection among all hemodialysis patients in EL Menofia governorate (sector A), 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 by years, Sex, Duration of hemodialysis by months, 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, Cause of chronic kidney disease. ••The study was done in April&May 2010. ••The total number of patients was 640 ones attending about 11 different center. ••The total number of –ve HCV patients from the start of their dialysis is 341 ones. 298 ones 0f them still free of HCV and 43 ones converted to positive state through out their duration of HD. ••This study revealed that, the total number of the HCV positive patients was 342 (53.27%), while the total number of the HCV negative patients was 298 (46.73%). ••our study included 400 male patients (62.5%) and 240 female patients (37.5%), the age of the patients ranged from 13 years to 86 years (mean 49.6 ± 16.2). ••The present study concluded that there is no significant relationship between the conversion in the hemodialysis patients and age or sex. ••Also the statistical analysis denoted that there is no significant relationship between the rate of conversion of the HCV negative hemodialysis patients and their duration of dialysis. ••In our study, the results showed significant correlation between the conversion of the hemodialysis patients to the HCV positive state and dialyzing in more than one center.••In our study, there is no significant relationship between the conversion to the positive HCV state and the type of vascular access while there is a significant relationship between the conversion to the positive HCV state and the number of catheters. ••the statistical analysis denoted that there is no significant relationship between the rate of conversion of the HCV negative hemodialysis patients and previous blood transfusion. ••In the present study, there was no relationship between conversion to HCV positive state and previous surgeries done. ••In our study, there is no significant relationship between the conversion to the positive HCV state and infection with HBV or with bilharziasis. ••In our study, there is no significant relationship between the conversion to the positive HCV state and family history of hepatitis. ••Finaly, many results highlight the importance of isolation as a policy to combat HCV infection among hemodialysis patients, this doesn’t agree with the present study which concluded that there is no significant relationship between the conversion in the hemodialysis patients and isolation neither by place nor by machine. 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 bloodborne pathogens . |