Cross Infections in Dialysis Units

A third of people who are on maintenance hemodialysis eventually get infected with a chronic viral disease. Isn’t this shocking?

The disease is usually Hepatitis C. Some people also get infected with Hepatitis B or HIV. Hepatitis C is a disease that affects the liver.

Cross infections happen when the blood of an infected individual comes into contact with the blood of an individual who is not infected. This can happen in dialysis units when the patient undergoes a blood transfusion and the blood of the donor has not been screened properly. Cross infections can also occur due to improper processes followed in the dialysis units. Especially during washing of dialyzers and bloodlines, there is a high chance of this happening. Therefore, it is advisable to opt for single use of dialyzer and bloodlines if you can afford it.

Once someone is infected with a virus such as Hepatitis C, there are more hurdles for a transplant. Most centers prefer giving a cadaveric kidney to a person who is negative (virus free) rather than someone who is positive. The treatment after a transplant also becomes more complex because the doctors have to keep in mind that the immunosuppression drugs can cause a flare up of the Hepatitis C virus causing further damage to the liver. Every decision needs to be taken keeping this in mind.

Until a few years back the treatments available for Hepatitis C were not very effective and the disease could also recur after successful treatment. Those therapies were mainly based on pegylated interferon and ribavirin. There were also some very unpleasant side effects. Luckily, these days, there are treatments available for Hepatitis C which are much better, more effective and with very less side effects. These are called “Direct Acting Agents” and include drugs such as Sofosbuvir, Ledipasvir and Daclatasvir. These treatments though effective are  quite expensive.

It is very important for you, as a dialysis patient to dialyze at a unit that takes cross infection prevention very seriously. Units must follow stringent processes. There are a set of published guidelines by the Center for Disease Control that lay down the procedures to be followed and the precautions to take to prevent cross infections in dialysis units. All centers must actively follow these guidelines.