الفهرس 
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Abstract
Hepatitis C virus (HCV) infection is considered a major public health
problem worldwide. Patients with chronic renal failure who are on hemodialysis (HD) have ahigh prevalence of antibodies to HCV. They are among the highest risk groups for the acquisition of HCV infection (Alavian et al., 2007).
Prevalence of HCV infection has decreased in this group(hemodialysis patients) in recent years (Espinosa et al., 2004). but still remains a significant public health concern. HCV-infected patients on HD have significant liver disease and a decreased life expectancy (Espinosa et al., 2004).
The relative risk for death in HCV infected patients on HD compared with non-infected patients is greater than 1.4 (Hanafusa et al., 1998). In addition, HCV infection leads to decreased graft and patient survival in renal transplant recipients (Hanafusa et al., 1998).
On the other hand, due to the increased prevalence of non-communicable diseases such as diabetes mellitus and hypertension, and their complications, chronic renal failure has become a more serious health issue throughout the world (Aghighi et al., 2008).Therefore, the clinical importance of HCV has been increasingly recognized in the dialysis community.
Several prophylactic measures have been suggested to avoid infection by HCV in the HD environment, and range from isolating patients with HCV infection (Rahnavardi et al., 2008).
To adopting a series of biosafetymeasures specific for HD, such as preparing medications in a separate area, cleaning and disinfecting dialysis station surfaces, washing hands and changing gloves between patient contacts, and items dedicated for use only with a single patient (Valtuille et al., 2002).
Strict adherence to universal infection control precautions seems to be enough to control the spread of disease in HD units (Valtuille et al., 2002).Some reports have recommended the adoption of infection control isolation measures at centers with a high HCV prevalence (Djordjević et al., 2000),or if the staff/patient ratio at the center is lower than 28/100 (Saab et al., 2001).
At centers with a high prevalence of HCV infection and in developing countries, universal precautions may not always be possible to implement. Thus isolation measures for HCV-positive patients should
be implemented (Barril&Traver., 2003).
The CDC recommends that special precautions be observed in dialysis units including the wearing and changing of gloves and water-proof gowns between patients; systematic decontamination of the
equipment, circuits, and surfaces after each patient treatment; no sharing of instruments (e.g. tourniquets) or medications (e.g. multiuse vials of heparin) among patients; and the assignment of patients to specific HD
units (Flett et al., 1998).
In our study about 1000 patient on regular hemodialysis subjected to our questionnaire (age, duration of dialysis,family history of HCV ,previous blood transfusions,previous surgery,causes of ESRD,history of shistisomas,switching dialysis and vascular acess).
Also from their files we gain data about (HCV , HBV status and timing of their seoconverion).
Also, we look for application of infective control mesauers and isolation procedures.
We find that (Age ,duration of hemodiaylsis,isolation procedures,family history and AV fistula) are the significant factors responsible for increase HCV antibodies among hemodialysis patients in Alexandria governate sector A (Montzah,Wassat and Shark areas).
Clearly, it is necessary to attempt, one step at a time, to minimize intradialytic or intracenter HCV transmission.