MP617THE ROLE OF DEDICATED REUSE MACHINE FOR ANTI HCV POSITIVE PATIENTS IN REDUCING THE INCIDENCE OF HEPATITIS C INFECTION IN HEMODIALYSIS UNIT: A TWO YEAR PROSPECTIVE STUDY

Abstract

Introduction and Aims: Hepatitis C virus (HCV) infection has an important role in causing chronic liver disease among maintenance hemodialysis (HD) patients. The HCV infection incidence is still increasing, although some effort have done, (e.g. minimalizing transfusion by adequating the erythropoeting stimulating agent, providing a good standard of infection control for medical staff, doing routinely anti-HCV screening every 6 months, and educating patients and their family about the mechanism of HCV transmission. The study evaluating HD reuse machines related to HCV transmission is still limited. The aim is to analyze the role of HD reuse machines dedication to the relative risk incidence of anti-HCV sero-conversion in HD unit of our hospital. Methods: We performed a 2 years prospective study among 46 maintenance HD patients (27 male), average age 52+/-11,7 years, average length of HD was 2.3+/-1.6 year. All patients using reuse-dialyzer, 3-times-weekly HD frequency, 4 hours duration every session, and followed from december 2013 until december 2015, informed consent and permission already given by them and nobody was die or drop out during the study. Laboratory screening of anti-HCV evaluation was done every 6 months. All data were analyzed statistically using Saphiro-Wilk method. Results: At the 1st screening we got n=0 anti-HCV(+) patient, then at the 2nd screening n=6 (RR=0,13) seroconversion to anti-HCV(+) patients. Therefore we intervened by separating the HD machines for anti-HCV positive to the negative, but still with one reuse machine. The result in the 3rd screening was n=4 (RR=0.80) seroconversion to positive, then we bought another reuse machines and separated the reuse machine (one was dedicated for anti-HCV positive, another for the negative). The result at the 4th screening was excellent, n=0 (RR=0) seroconversion was found. In order to make sure about the result, we did the 5th screening, which shown n=1 (RR=0.02) seroconversion to positive. Conclusions: Consideration to use a dedicated reuse machine for anti-HCV positive patients separated from the negative ones can reduce the incidence of HCV infection in hemodialysis unit which using a reuse dialyzer