Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com The Opposite View Nephron Clin Pract 2011;117:c328–c332 DOI: 10.1159/000319984 Hemodialysis of Patients with HCV Infection: Isolation Has a Definite Role S.K. Agarwal  Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India HCV prevalence has declined in many dialysis centers. However, it still remains unacceptably high, ranging from 8 to 10% even in the most industrialized countries [2]. Thus, there is still scope of reduction of HCV in MHD. HCV Spread during MHD HCV seroconversion had been noted in patients who were never transfused. Further, clinical experience in a dialysis unit [1], outbreaks of HCV infection in a unit [3] and phylogenetic analysis of HCV isolates [4, 5] all sug- gest that the nosocomial route of transmission plays the key role in HCV transmission. Occasionally, a ruptured dialyzer has been put forward as a potential risk for HCV transmission [6]. Other investigators suggested the use of a lower transmembrane pressure in patients with HCV infection [7]. Sartor et al. [8] provided evidence for HCV transmission between 2 patients sharing the same ma- chine and suggested possible transmission via accidental contamination of the venous pressure monitoring sys- tem. Presence of HCV-RNA had been demonstrated on the hands of dialysis personnel. All these lines of evidence indicate different modes of nosocomial HCV transmis- sion in a hemodialysis unit. Key Words HCV  Hepatitis  Infection control  Hemodialysis  Isolation Abstract HCV infection in patients on hemodialysis varies from 10 to 60% in various centers. There is controversy regarding the isolation of patients with HCV infection during hemodialysis. Guidelines developed by the Centers for Disease Control and Prevention do not suggest isolation of these patients. In this opposite view, evidence is being given to support the view that there is a definite role of isolation of HCV-infected pa- tients during hemodialysis. Copyright © 2010 S. Karger AG, Basel Introduction Patients with end-stage renal disease (ESRD) on maintenance hemodialysis (MHD) are at increased risk for acquiring HCV infection. Prevalence of HCV infec- tion varies greatly, from ! 5% to nearly 60% according to different areas of the world [1]. The prevalence is consis- tently associated with MHD duration and the number of transfusions. With the introduction of routine HCV screening and with increased attention to prevent spread, Published online: November 3, 2010 Prof. Sanjay K. Agarwal Department of Nephrology All India Institute of Medical Sciences New Delhi 110029 (India) Fax +91 112 658 8663, E-Mail skagarwal58  @  yahoo.co.in © 2010 S. Karger AG, Basel 1660–2110/11/1174–0328$38.00/0 Accessible online at: www.karger.com/nec