Hepatitis Type A and Hemodialysis

Abstract

Patients and staff (460) from 15 USA dialysis centers were surveyed by the immune adherence hemagglutination technique for antibody to hepatitis A antigen (anti-HA). The age-standardized anti-HA prevalence was 42.9% in patients and 42.1% in staff. These rates are almost identical to those of socioeconomically comparable urban volunteer blood donors never exposed to dialysis settings. There was no correlation between anti-HA prevalences and duration of dialysis treatment or employment. Among 100 patients and staff followed for 1 yr 92-94% did not change their anti-HA status. The prevalence of anti-HA was identical in subjects with past histories of multiple blood transfusions or accidental inoculations with blood-contaminated instruments and in those without such histories. Apparently, hepatitis A virus rarely if ever spreads by parenteral mechanisms, there is no epidemiologic evidence confirming the existence of chronic hepatitis A viremic carrier states and hemodialysis does not play a significant role in the spread of type A hepatitis.