الفهرس 
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Abstract
HCV infection still remains a major health problem that can cause substantial liver related morbidity and mortality in patients with ESRD.
The prevalence of hepatitis C virus (HCV) infection is estimated to be 2% worldwide, Egypt has the largest epidemic of hepatitis C virus (HCV) in the world with 14.7% of the population are infected with HCV.
The prevalence of anti-HCV positivity among dialysis patients varies in different countries from (3%-75% worldwide), unfortunately Egypt also is considered one of the countries with the highest prevalence.
This work is a part of project aiming to survey about HCV among HD patients, assessing its prevalence, seroconversion and study risk factors associated with HCV seroconversion among hemodialysis patients in Egypt. This project is modulated by the nephrology department, Ain Shams University.
This study was conducted upon 800 ESRD patients on regular HD sessions attending 9 different HD units in El Behira governorate sector B, districts included in this study were Markaz Badr city, Gharb Elnoubaria city, Kom Hamada city,Eldelengat city,Shobrakhit city, Al Mahmoudia city,Wadi Alnatroun city, Rasheed city and Hosh Eisa city. All patients were evaluated using a questionnaire form for assessment of risk factors claimed to be responsible for HCV seroconvergence among HD patients such as; age by years, gender, duration of hemodialysis, previous blood transfusion, previous surgery, isolation procedures in the centers, dialysis in other centers (switching dialysis centers), vascular access used, history of shistozomiasis, family history of HCV, cause of chronic kidney disease.
Among a total number of 800 patients attending 9 HD units, 488(61%) of them were males, with 312(39%) females.
The prevalence of HCV Ab at the start of dialysis was (41.75%), & the prevalence of HCV Ab by the time of data collection was (46.13%) with a rate of seroconversion of (7.51%), after a mean duration of HD since starting dialysis of 72 (± 45.03) month.
The present study revealed that there was neither significant correlation between HCV seroconversion in dialysis patients and age nor sex.
Also infection control measures, previous surgery, vascular access, and shistozomiasis were not significant risk factors for HCV seroconversion.
The study revealed significant correlation between HCV seroconversion in the HD patients and the following risk factors (blood transfusion, family history of HCV,switching between dialysis centers and duration of heamodialysis).
Isolation procedures(room isolation) was significant in univariate analysis and not significant in multivariable analysis. Finally, this study showed that successful prevention and control of HCV transmission in HD units in El Behira-Egypt was a multifactorial including un-modifiable factors (like duration of dialysis), and modifiable factors including (a) implementation of strict infection control guidelines with standard precautions, (b) minimizing blood transfusion and expanded use of erythrobioetin.