TY - JOUR
TI - Molecular epidemiology of a hepatitis C virus outbreak in a
haemodialysis unit
AU - Katsoulidou, A
AU - Paraskevis, D
AU - Kalapothaki, V
AU - Arvanitis, D and
AU - Karayiannis, P
AU - Hadjiconstantinou, V
AU - Hatzakis, A
AU - Multicentre
AU - Haemodialysis Cohort Study Viral He
JO - Nephrology Dialysis Transplantation
PY - 1999
VL - 14
TODO - 5
SP - 1188-1194
PB - Oxford University Press
SN - 0931-0509, 1460-2385
TODO - 10.1093/ndt/14.5.1188
TODO - genotyping; haemodialysis; hepatitis C virus; nosocomial infection;
nucleic acid sequencing; phylogenetic analysis
TODO - Background. Haemodialysis patients are at high risk of infection by
hepatitis C virus. The aim of this study was to investigate a hepatitis
C virus outbreak which occurred in a haemodialysis unit, using
epidemiological and molecular methods.
Methods. Five seroconversions to hepatitis C virus antibody (anti-HCV)
were observed over a 6 month period and these were added to the four
previously recorded anti-HCV-positive patients. All nine patients
involved in the outbreak were tested for HCV RNA by reverse
transcription-polymerase chain reaction and hepatitis C genotype
determination was accomplished by a reverse hybridization assay.
Furthermore, part of the NS5 region of hepatitis C genome (nucleotide
positions 7904-8304) was amplified and sequenced in all HCV RNA-positive
patients. Then, phylogenetic analysis of the nucleotide sequences
obtained was carried out in order to investigate any possible
epidemiological linkage among patients. Detailed epidemiological records
were also available for all haemodialysis patients.
Results. Samples from all five incident cases and three out of four
prevalent HCV infections were found positive for HCV RNA. HCV genotyping
studies revealed that all incident cases were classified as 4c/d,
whereas one and two prevalent cases were la and 4c/d respectively.
Sequence comparisons and phylogenetic tree analysis revealed that six of
the patients harboured very similar strains and clustered together,
including all incident and one prevalent case, which was implicated as
index case. Further epidemiological analysis was consistent with patient
to patient transmission.
Conclusions. Molecular and epidemiological analysis suggested that
horizontal nosocomial patient to patient transmission was the most
likely explanation for the virus spread within the haemodialysis unit
under study.
ER -