Prevalence of human immunodeficiency virus, hepatitis B virus and hepatitis C virus among dialysis patients. The Italian Multicentric Study on Nosocomial and Occupational Risk of Blood-Borne Infections in Dialysis

In April 1991, a cross-sectional study of HIV, HBV and HCV markers among dialysis patients was carried out in 19 Italian units in order to evaluate the spread of these bloodborne infections among patients and to evaluate the potential risk for staff who care for them. A total of 2,180 patients were eligible and all consented to be tested. Of the 1,347 patients who had not been given hepatitis B vaccine, 67.9% had at least one marker of HBV infection; of these 9.2% were HBsAg carriers; conversely, the rates were 7.6 and 0.4%, respectively, among the 833 vaccinated patients. Antibodies against HCV were found in 501 patients (23%) by EIA C100-3; of these, 270 were tested by RIBA-100: 246 (91%) were reactive and 11 (4.1%) indeterminate. Five patients resulted anti-HIV positive [0.22%, 95% CI (Poisson distribution): 0.07-0.53] by EIA and Western blot techniques. Length of time on dialysis seems to correlate with higher prevalence of HBV and HCV infection markers, but (not) HIV. Overall, 608 (28%) patients were a potential source of infections for other patients and staff. This emphasizes the need for stricter adherence to infection control, barrier precautions and preventive behaviours with all patients.