[Hepatitis B and C infection as a part of hospital acquired infection at the Renal Dialysis Unit in Assiut University Hospital]

Background: Hospital-acquired hepatitis B [HBV] and C virus [HCV] infections continue to occur despite increased awareness of this problem among the medical community. Infection with hepatitis viruses continues to be a major concern for hemodialysis patients, who are recognized as a high-risk group

Objectives: To measure the HBV and HCV seroconversion in hospitalized patients at the hemodialysis unit in Assiut University hospital and to assess the potential risk factors for infection with these viruses in this unit

Methods: This study was performed in Assiut University Hospital at the renal dialysis unit. A total of 63 patients on regular hemodialysis who should be negative for anti HCV, HBsAg and IgG anti HBc with normal liver enzymes and abdominal ultrasound were included in this study between June 2011 and August 2014. An identification questionnaire for possible risk factors for HBV and HCV was done at the start of study. Then follow up after 3 months with another questionnaire for the risk factors and screening by anti HCV, HBsAg and IgM anti HBc were done. Then another follow up after 6 months with other questionnaire for the risk factors and screening by anti HCV and HBsAg. Qualitative PCR test for HCV was used for patients whose results were positive for anti HCV either at 3 months or 6 months follow up. The study also include 12 health care workers and they were screened for anti HCV and HBsAg. Their history of vaccination for HBV was also assessed. Assessment of adherence to infection control measures was also done

Results: Twenty one patients were anti HCV positive, seven of them were positive after 3 months follow up and 14 were positive after 6 months follow up with seroconversion rate of 33.3%. No patient was positive for HBV throughout the study period. All these positive for anti HCV were negative for qualitative PCR for HCV All the included health care workers were negative for HBV and HCV markers. Furthermore all of them had complete vaccination for HBV. The potential risk factors for HCV seroconversion were duration and frequency of dialysis, blood transfusions, dialysis with patients positive for HCV in the same room, lack of strict adherence to infection control measures by the health care workers

Conclusion: Regular screening of all patients and health care workers in hemodialysis units for HBV and HCV with improvements in infection control practices should be done. Therefor health education of the health care workers and their vaccination against HBV infection should be considered

Respiratory symptoms and pulmonary functions in patients with chronic hepatitis C infection

Extra-hepatic manifestations of hepatitis C virus [HCV] infection are common. The interaction between chronic hepatitis C virus [HCV] infection and chest diseases is of considerable interest. Chronic hepatitis C viral infection has been incriminated as an aetiological agent that increases the risk for development of COPD and idiopathic pulmonary fibrosis. This prospective study was designed to determine chest symptoms and the effects of chronic hepatitis C virus [HCV] infection non lung functions in two groups of patients. Design: Prospective observational study. Setting: Assiut University Hospital. Patients: Fifty-two patients with chronic hepatitis C vieral infection [group 1, 35 HCV-positive patients with liver cirrhosis; group 2, 17 HCV-positive patients without liver cirrhosis]. The most common reported chest symptom among either group was dysnea [52.29%] for group 1, and [29.41%] for group 2. Arterial blood gases [ABGs] results were pH of 7.39 +/- 0.4 for group 1 and 7.38 +/- 0.3 for group 2, partial arterial tension of carbon dioxide [PaCO[2]] of 37.9 +/- 7.19 mm Hg for group 1 and 43.07 +/- 5.39 for group 2, partial arterial tension of oxygen [PaO[2]] of 87.0 +/- 9.58 mm Hg for group 1 and 89.12 +/- 8.5 for group 2, arterial O[2] Sat of 96.1 +/- 2.2 for group 1 and 96.85 +/- 1.39 for group 2, and alveolar-arterial gradient of 22 +/- 11 mm Hg for group 1 and 13 +/- 1.2 for group 2. Despite higher impairment of ABGs levels among group 1, this was statistically not significant for all parameters [P > 0.05]. Eight patients [15.4%], 5 in group 1 and 3 in group 2 had pulmonary function tests parameters that were within normal range, 9.6% had obstructive airway disease, 51.9% had restrictive lung impairment, 15.4% had combined obstructive and restrictive dysfunction and 7.7% had small airway obstruction. Restrictive lung impairment was significantly the commonest type of pulmonary dysfunction [P <0.05]. Various pulmonary function test abnormalities did not lead to significant differences in arterial blood gases. Our findings suggest that pulmonary changes were frequent in patients with chronic hepatitis C virus infection. The commonest form of pulmonary dysfunction is restrictive pattern. Despite the lack of much pulmonary symptoms; however, dyspnoea was the most commonly reported one