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Hepatitis C virus (HCV) infection, unrelated to blood transfusion is very common among hemodialysis patients with chronic renal failure. The positivity rate for anti-HCV varies from 18% to 91% among various countries. It is due not only to the past blood transfusions, but also to nosocomial transmission which is preventable. The main route of virus entry, is most likely, the two (arterial and venous) needle holes that are touched by the fingers of the physi-cian and the nurse repeatedly. The recommended preventive measures include: the use of a sterile glove, finger sterilization with a disinfectant solution, immediately before touching the needle/needle hole. and repeated education of the staff. Whether the anti-HCV positive patients should be separated from the negative, largely depends on the prevalence of HCV infection within the dialysis unit.

Hepatitis is an inflammatory viral infection of the liver transmitted from one infected person to another by personal contact. Historically, hepatitis cases have been categorized into hepatitis A and hepatitis B, each caused by a distinct strain of virus. Cases that do not fit the diagnostic criteria for either strain of virus have been classified non-A, non-B hepatitis. It is now thought that a third, less well characterized strain of the virus, hepatitis C, may be responsible for many of these cases. It has been reported that alpha-interferon (a protein produced when cells are exposed to viral invasion) improves not only biochemical markers (i.e. it ameliorates the increase in blood aminotransferase seen in this type of hepatitis), but improves the microscopic anatomy of the liver in hepatitis patients. A double-blind, placebo controlled prospective study was carried out with 49 Japanese patients to further investigate the efficacy of alpha-interferon in treating non-A, non-B hepatitis. Patients received either relatively large doses (3 million units) of recombinant human alpha-interferon (24 patients) or inactive placebo (25 patients) three times weekly for eight weeks. Blood levels of alanine aminotransferase (an amino acid-metabolizing enzyme) were decreased by over half in the drug treated patients; no change was seen in the placebo treated group. Liver biopsies taken before and after treatment revealed a dramatic improvement in liver anatomy only in the alpha-interferon treated group. Hepatitis C patients were identified by the presence of anti-hepatitis C antibody in their blood; alpha-interferon treatment was equally effective in antibody-positive and antibody-negative patients. However, there was no reduction in the number of patients testing positive for hepatitis C virus following treatment with alpha-interferon. (Consumer Summary produced by Reliance Medical Information, Inc.)