الفهرس 
coverOnly 14 pages are availabe for public view
 |  | from | 169 |  |  |
| | | from | 169 | | |
Abstract
( HCV ) Virus is a positive stranded RNA Virus classified as family flavivirdae, genus hepacivirus and it is a major public health problem with an estimated 170 million person being infected with this agent around the World .
Patients undergoing haemodialysis are at high risk of acquiring this blood borne pathogen, since ( HCV ) is Efficiently transmitted by the parenteral route.
In addition, infected patients have an increased tendency to develop chronic hepatitis and to be also a potential reservoir for its transmission, possibly contributing to the nosocomial spread of ( HCV ) in dialysis centers and explaining the high prevalenc of ( HCV ) infection among Haemodialysis patients .
Hepatitis C Virus ( HCV ) prevalence differs among Haemodialysis units according to their geographical location, health care procedure, Socioeconomic Factor, hygiene, sterilization of equipment, repeated blood transfusion and the number of years on dialysis
( HCV ) causes both acute & chronic hepatitis. So the detection of acute ( HCV ) infection was carried out through monthly ALT ) & Anti ( HCV ) markers observation or detection of the virus by PCR .
Elevation in serum ( ALT ) Level often precede Anti ( HCV ) seroconversion. It should be noted that antibody in haemodialysis patient makes slower appearance than in non haemodialysis patient & seroconversion may depend on each patient response, so diagnosis of ( HCV ) infection also can be made by qualitatively detecting ( HCV ) RNA using gene Amplification techniques e.g ( PCR )
This study aimed at defining the prevalence of HCV among HD patients in El-Beheira governate(sector A).
It was conducted on 999 CKD stage 5 patients on regular HD in 6 cities in El-Beheria governate. The survey was designed to collect data readily available in the dialysis units and focused on patients data and investigations results.
The patients data including age, sex, previous surgical interventions,HCV at start of dialysis,HBV,previous schistosomal infection, etiology of CKD.
The HD data including: frequency and duration of HD for patients,isolation policy in the H.D units,previous blood transfusion,switching of dialysis in other centers and application of infection control measures
It was found that:
• HCV infected patients were 47.25%, HBV infected patients were 15.62%, combined HCV and HBV were 4.50% .HCV antibodies free were 52.75% while the HCV seroconvertion rate was 14.95%.
• Out of the 999 patients 55.05% were males and 44.95% were females and the mean age was 47.34±13.159 years.
• The most common etiology of renal failure was hypertension (33.05%)
• Statistical significant association was found between HCV with previous schistosomal infection,previous HBV infection and switching between H.D places and the 2_nd vascular access.
• No statistical significant association was found between HCV and duration of dialysis,previous blood transfusion, Age and sex of the patient,previous surgical infection and isolation procedures applied in the H.D units
• No Statistical significant association was found between HCV and application of infection control measures,this may be due the late and improper application of these measures.
In conclusion:
The prevalence of HCV infection in Haemodialysis patients in El-Beheira governate (sector A) was: 47.25%
And seroconvertion rate was 14.90% and the most important risk factors were HBV infection,switching of dialysis in other centers and bilharaziasis.
Recommendations for preventing transmission of ( HCV ) infection among haemodialysis units include :-
1- Reeducation of the existing staff members regarding recommended infection control practice for haemodialysis
2- All the equipment used on patients with positive serology such as stethoscope, sphygmomanometer were separated .
3- haemodialysis machines were sterilized after each session of dialysis with persteril 3,5{ Peracetic acid 3,5% } and externally cleaned with soap and water
4- The health – care worker from the unit were examined for Anti
( HCV ) markers .
5- Advise the patient to confine to his place of haemodialysis,if patient need urgent switch ,HCV Abs must be done before H.D session.