Mon Dec 31, 2007 4:44 am (PST)
J Med Virol. 2008 Feb;80(2):261-7.
Molecular epidemiology of a hepatitis C virus outbreak in a hemodialysis unit
in Italy.
Spada E, Abbate I, Sicurezza E, Mariano A, Parla V, Rinnone S, Cuccia M,
Capobianchi MR, Mele A.
Istituto Superiore di Sanità, National Centre of Epidemiology, Surveillance and
Health Promotion, Rome, Italy.
Hemodialysis patients are at increased risk of hepatitis C virus (HCV)
infection. The aim of this study was to investigate a HCV outbreak in a
hemodialysis unit using epidemiological and molecular methods. Between April
2003 and October 2003, anti-HCV seronconversion was detected in four patients
attending the unit. These cases were added to 10 patients already anti-HCV
positive upon admission in the unit. All 14 anti-HCV patients were tested for
HCV RNA and HCV genotype. NS5B and HVR1/ E2 genomic regions were amplified and
sequenced in all HCV RNA positive patients and phylogenetic analysis was
performed. Furthermore, clinical-epidemiological records obtained from all
patients were examined. All four patients newly infected harbored genotype 2c.
Genotype 2c was also detected in 2 of 10 patients already anti-HCV positive upon
admission. Phylogenetic analysis showed that all newly HCV infected patients
harbored very closely related viral isolates that clustered together
with the 2c isolate found in one of the two 2c chronic infected patients. All
HCV-2c infected patients had no other risk factors except hemodialysis. Three of
four newly HCV-2c infected patients and the one HCV-2c chronically infected
involved in the outbreak received dialysis on the same day and same shift but
used different machines. The remaining HCV-2c newly infected patient and one of
the above cited three received dialysis on the same day during different shifts
but used the same machine. The outbreak was probably due to breaks of infection
control procedures although a related-machine transmission cannot be excluded in
one of the cases. J. Med. Virol. 80:261-267, 2008. (c) 2007 Wiley-Liss, Inc.
PMID: 18098132 [PubMed - in process]



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