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Nosocomial transmission in simultaneous outbreaks of hepatitis C and B virus infections in a hemodialysis center

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Abstract

Reported here are details of a simultaneous outbreak of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections that occurred in a hemodialysis centre in northern Italy, with three patients seroconverting for HBsAg and four patients seroconverting for HCV antibodies. Phylogenetic analysis of the E2 region of the isolates from HCV-seroconverted patients showed the sequences were grouped in the same distinct branch as in a chronically HCV-infected patient, suggesting that the chronically infected patient was the index case. For the patients with HBV infection, phylogenetic analysis showed strong clustering among the sequences of the three patients who seroconverted to HBsAg and no relatedness between them and the sequences of patients chronically infected with HBV. For one of the patients who seroconverted to HBsAg, the last test with negative results for HBV markers had been performed 18 months prior to HBsAg seroconversion. This patient may have been previously infected with HBV and is presumed to be the source of the outbreak. This report emphasizes the importance of using universal precaution measures and HBV vaccination to prevent the transmission of viral hepatitis among chronic hemodialysis patients.

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Acknowledgements

The authors wish to thank P. Collinassi, P. Dello Russo, M. Messa, G. Mioni, and A. Romano for their help with data and sera collection, and G. Di Candia and A. Sagulo for their technical assistance. Gratitude is also expressed to M. Kanieff for editorial and linguistic revision of the manuscript and to R. Tomasetto for editorial assistance.

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Authors and Affiliations

  1. Viral Hepatitis Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy

    L. A. Kondili, D. Genovese, C. Argentini, P. Chionne & M. Rapicetta

  2. Medical Hospital Direction, Azienda Ospedaliera “Santa Maria della Misericordia”, Piazzale della Misericordia, 15, Udine, Italy

    P. Toscani, R. Fabro & R. Cocconi

Authors
  1. L. A. Kondili
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  2. D. Genovese
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  3. C. Argentini
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  4. P. Chionne
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  5. P. Toscani
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  6. R. Fabro
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  7. R. Cocconi
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  8. M. Rapicetta
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Corresponding author

Correspondence to M. Rapicetta.

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Kondili, L.A., Genovese, D., Argentini, C. et al. Nosocomial transmission in simultaneous outbreaks of hepatitis C and B virus infections in a hemodialysis center. Eur J Clin Microbiol Infect Dis 25, 527–531 (2006). https://doi.org/10.1007/s10096-006-0162-7

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  • DOI: https://doi.org/10.1007/s10096-006-0162-7

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