Hepatitis C among Hemodialysis Patients: A Review on Epidemiologic, Diagnostic, and Therapeutic Features

Hepatitis c virus (hcv) is a major public health problem and is the most common liver disease among hemodialysis (hd)patients. the seroprevalence of hcv infection among hd ranged from 1.9% to 80% in reports published since 1999.the main risk factor for hcv acquisition in hd patients seems the length of time on hd. phylogenetic analysis of hcvviral isolates has suggested nosocomial patient-to-patient transmission of hcv infection among hd patients. lack ofstrict adherence to universal precautions by staff and sharing of articles such as multidose drugs might be the mainmode of nosocomial hcv spread among hd patients. currently, there are several dilemmas on the management of thesepatients: should hcv-rna testing be included in the routine screening of hd population for hcv infection?; doesperiodic serum alanine aminotransferase testing have a role in screening hd patients for hcv infection?; can dialysisreally 'save' the liver of hcv-infected hd patients?; should hcv-infected subjects be isolated and dialyzed by segregatedmachines?; is there any difference in treating hd and non-hd hcv-infected subjects? this article gathers the presentevidence to address these issues and to demonstrate the current worldwide magnitude of hcv in hd population.