Prevalence of antibodies to hepatitis C virus in a Dutch group of haemodialysis patients related to risk factors

Abstract

In January 1992, 122 chronic haemodialysis patients (>9 months dialysis) from the University Hospital Utrecht and its outpatient dialysis facility were tested for the presence of anti-hepatitis C virus (HCV) antibodies. The objective was to identify risk factors for HCV infection in chronic haemodialysis patients in an attempt to explain the high prevalence of anti-HCV antibodies found among such haemodialysis patients. A second generation enzyme linked immuno-sorbent assay (EIA) was used as a screening test. Results were confirmed by a recombinant immunoblot assay and by the polymerase chain reaction (PCR). Four (3·3%) of 122 patients reacted positively in the EIA screening test as well as in the immunoblot assay; three of these were positive using PCR. None of the patients with anti-HCV antibodies had received blood products other than blood from transfusions, none had markers for a hepatitis B virus (HBV) infection or admitted intravenous drug abuse. A total number of 2395 units of blood, unscreened for HCV, had been administered to our dialysis group, an average of 19·6 ( sd 44·7) units per patient. The seroprevalence of anti-HCV antibodies among blood donors in Utrecht was 0·03%. Patients with antibodies to HCV had been on dialysis longer than those dialysis patients without HCV antibodies (odds ratio 1·8, 95% CI 0·99-3·29). We conclude that the risk for HCV infection for this dialysis group can only partially be attributed to unscreened blood transfusions. Haemodialysis itself may play a role in transmission of HCV.