Molecular epidemiology of an outbreak of HCV in a hemodialysis unit: Direct sequencing of HCV-HVR1 as an appropriate tool for phylogenetic analysis

• Published in: Journal of medical virology 2000-02, Vol.60 (2), p.152-158
• Main Authors: Grethe, Stefanie, Gemsa, Friederike, Monazahian, Masyar, Böhme, Ingo, Uy, Angela, Thomssen, Reiner
• Format: Article
• Language: English
• Subjects: Adult; Aged; anti-HCV; Base Sequence; Biological and medical sciences; Cross Infection - epidemiology; Cross Infection - virology; Epidemiology; Female; Fundamental and applied biological sciences. Psychology; Genotype; Germany - epidemiology; Hemodialysis Units, Hospital; Hepacivirus - classification; Hepacivirus - genetics; Hepatitis C - epidemiology; Hepatitis C - virology; Hepatitis C virus; Human viral diseases; Humans; HVR1 gene; Infectious diseases; Male; Medical sciences; Microbiology; Middle Aged; Molecular Sequence Data; nosocomial transmission; phylogenetic tree; Phylogeny; Retrospective Studies; Reverse Transcriptase Polymerase Chain Reaction; RT-PCR; Sequence Analysis, DNA; Sequence Homology, Nucleic Acid; Viral diseases; Viral hepatitis; Viral Proteins - genetics; Virology
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/(SICI)1096-9071(200002)60:2<152::AID-JMV8>3.0.CO;2-I

Infection with hepatitis C virus (HCV) is still a serious problem in hemodialysis patients, despite screening of blood products for anti‐HCV antibodies. The prevalence of HCV in HD patients is between 15% and 30% in Germany. We report the molecular epidemiology of an HCV outbreak in a hemodialysis unit in 1997 is determined. HCV hypervariable region 1 (HVR1) was amplified from serum samples of 19 patients by polymerase chain reaction (PCR) and sequenced directly. In addition, HCV isolates from 3 of these 19 patients were cloned and sequenced. 14 newly infected patients and two patients, who had been infected for several years had very closely related HCV isolates. Unrelated HCV isolates as well as sequences obtained from an HCV outbreak in a plasmapheresis center were found in different, distantly related branches. These findings provide strong evidence for nosocomial transmission of the virus, despite following strict general hygiene precautions. The production of anti‐HCV antibody was delayed significantly or seroconversion did not occur at all during the period of observation in 8 out of 14 newly infected HCV RNA positive patients. Close‐meshed reverse transcription‐polymerase chain reaction (RT‐PCR) analyses on apparently non infected patients within hemodialysis units and upon admission of new patients is strongly recommended for the early detection and prevention of outbreaks of HCV. J. Med. Virol. 60:152–158, 2000. © 2000 Wiley‐Liss, Inc.