Reports of hepatitis C infections among dialysis patients in the United States are rising, largely because of poor infection control practices, health officials say.
Between 2014 and 2015, the U.S. Centers for Disease Control and Prevention received reports of about 36 cases of hepatitis C infection at 19 kidney dialysis clinics in eight states.
So far, investigators have determined that patient-to-patient transmission of hepatitis C occurred at nine of those clinics.
Lapses in infection control procedures — such as injection safety, cleaning and disinfection, and hand hygiene — were common at these clinics, the CDC reported Wednesday. The exact means of hepatitis C transmission could not be pinpointed, but all of these deficiencies could contribute to transmission of the virus.
Hepatitis C, which can cause lifelong liver disease, is spread primarily through contact with the blood of an infected person, according to the CDC.
Improved screening and awareness of the risk of hepatitis C infection in dialysis facilities could partly explain the rise in the number of reported infections, the agency said in a news release.
Whatever the causes, the report “underscores the widespread potential for patients to acquire serious infections during dialysis care,” the CDC said.
Hepatitis C “transmission can be prevented when proper infection prevention and environmental disinfection practices are consistently followed,” the CDC added.
Dialysis is a life-saving treatment for people with advanced kidney disease. In the United States, about 400,000 such patients undergo dialysis each year, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.
The CDC pointed out that all dialysis facilities need to continually assess and improve their infection control, hepatitis C screening practices, and cleaning and disinfection methods, whether or not infections have occurred among their patients.
Any new case of hepatitis C infection in a dialysis patient is likely to be a health facility-associated infection and should be promptly reported to public health authorities, the CDC said.
Noting that one hepatitis C outbreak at a dialysis facility lasted five years before being detected, the agency said screening is essential to identify infections early and prevent further transmission.
The CDC urges dialysis facilities to follow their recommendations to help prevent and detect hepatitis C infections. The agency also offered the following advice to dialysis patients:
- If you do not know if you have or might have hepatitis C, ask your health care provider.
- Ask your dialysis provider if it follows CDC recommendations, whether you need to be tested for hepatitis C, and what can be done to protect you from hepatitis C infection during dialysis treatment.
- Read educational material for patients on dialysis safety and hepatitis C.
The National Kidney Foundation has more about dialysis patients and infectious diseases.