Adhering to screening recommendations for patients with hepatitis C who are treated at dialysis centers is mportant, as following these recommendations could potentially prevent spread of infection to other patients, according to a Notes From The Field report published in a recent Morbidity and Mortality Weekly Report

According to background information in the report, a patient enrolled in a dialysis clinic in March 2010, and had tested negative for acute hepatitis C virus (HCV) every year until testing positive for HCV antibodies on Dec. 18, 2013.  Investigators reported that the patient had no behavioral risk factors, but there were “multiple health care exposures.”

After the patient was identified, health department officials observed infection control practices at the dialysis clinic. They noted that although hygiene protocols were followed, “laboratory findings, the common station use, and the absence of other shared exposures support infection of patients A and B during dialysis at the clinic.”


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Patient A underwent dialysis on the same machine after patient C during January through May 2013. 

Investigators retested 62 dialysis patients for HCV. They noted 9 patients, including patient A, who were HCV-infected. Specimens from the index patient and 5 chronically-infected dialysis patients were positive for HCV genotype 1a, the most prevalent in the United States, and the remaining 3 patients were infected with genotype 1b.

CDC officials recommend that “dialysis patients have anti-HCV testing performed every 6 months” and that “any new seroconversions should be reported to local health departments.” The investigators writing in this report noted this example demonstrated why these protocols are so important.

“More rigorous HCV screening regimens, combined with timely reporting of seroconversions to public health officials, will facilitate investigation and infection control improvement recommendations to prevent future infections,” the researchers concluded. “Even a single reported case of acute HCV infection in a hemodialysis patient warrants health department investigation, because it might represent intra-facility transmission.”

Reference

1. Muleta D, Kainer M, Moore-Moravian L, et al. Notes from the Field: Hepatitis C Outbreak in a Dialysis Clinic—Tennessee, 2014. MMWR. 2016;64(50);1386-7.