Korean Journal of Nephrology 1996;15(2):176-183.

투석중인 환자에서 시향한 c형 간염에 대한 연구

도준영 , 박종원 , 윤경우 , 김용림 , 조동규 , 강영모

Abstract

This study has been designed to evaluate the cause of higher prevalence of hepatitis C on dialysis patients than general population. A survey of 225 adult dialysis patients(HD 171,CAPD 54) was carried out to determine the seroprevalence of hepatitis C in the three renal unit in Taegu on the 1st July 1994. The results were as follows. 1) The mean prevalence of HCV Ab in the three renal units was 8.9%(20/225) and that of HCV PCR of the selected patients was 17.3%(9/52). 2) The positivity of HCV Ab and HCV PCR was significantly correlated with the duration of dialysis (p<0.05). 3) Patients who received dialysis from a recir- culating single pass(RSP) hemodialysis machine showed significantly higher HCV PCR positivity than patients who did not receive dialysis from RSP(42.9% vs 9.4%, p<0.05). 4) HCV positivity was not significantly correlated with pretransfusional HCV screening or by the total individual transfusion amount. 5) There was no significant difference in HCV positivity between HD and CAPD or between the isolated dialysis center and two non- isolated dialysis center, but the duration of dialysis treatment was significantly longer in the isolated center(47 vs 33 months). 6) HD patients who had previously undergone renal transplantation had slightly higher HCV posi- tivity than patients who didn't undergo renal transplants (statistically not significant). 7) There has been no seroconversion in the dialysis patients from negative HCV Ab to positive HCV Ab since 1991. 8) There was no evidence of hepatitis C viral contamination in the dialysate of HCV PCR positive patients during hemodialysis. In Conclusion, HCV positivity was significantly correlated with the number of years the patient received dialysis treatment and not with the amount of blood transfusion or pretransfusional HCV screen- ing. The RSP dialysis machine might play an important role in HCV transmission in the hemodialysis center. There was no seroconversed patient during the follow up period, which means currently used HD machine and methods of disinfection are good for preventing transmission of HCV. But HD isolation is still the recommended method in order to reduce the risk of transmission of HCV at present. Further studies of another transmission route of HCV in the dialysis room is needed.