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 global prevalence of hepatitis C virus (HCV) infection estimated to be around 1.6 - 3% worldwide, Egypt has the largest epidemic of hepatitis C virus (HCV) in the world with 10 - 13% of the population 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 987 ESRD patients on regular HD sessions attending 22 different HD units in Cairo governorate sector B (North Cairo), districts included in this study were El-zawia El-hamraa, El-sharabia, Elzaiton, Rod El-farag, Shobra, El-sahel and Hada’ek Al-kobba.
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, history of HBsAg, family history of HCV, cause of chronic kidney disease.
Among a total number of 987 patients attending 22 HD units, 552 (55.9%) of them were males, with 435(44.1%) females.
The prevalence of HCV Ab at the start of dialysis was (45.2%), & the prevalence of HCV Ab by the time of data collection was (51%) with a rate of seroconversion of (10.7%), after a mean duration of HD since starting dialysis of 3.35 (± 2.048) years.
The present study revealed that there was neither significant correlation between HCV seroconversion in dialysis patients and age nor sex.
Also family history of HCV, previous surgery, isolation procedures, HBV infection and shistozomiasis were not significant risk factors for HCV seroconversion.
Vascular access (whether Catheter or AVF) was significant in univariate analysis and not significant in multivariable analysis.
On the other hand, Duration of HD was not significant in univariate analysis and significant in multivariable analysis.
The study revealed significant correlation between HCV seroconversion in the HD patients and the following risk factors (blood transfusion, switching dialysis centers, and infection control measures).
Finally, this study showed that successful prevention and control of HCV transmission in HD units in Cairo-Egypt was a multifactorial including un-modifiable factors (like duration of dialysis, age), and modifiable factors including (a) implementation of strict infection control guidelines with standard precautions, (b) minimizing blood transfusion and expanded use of erythrobioetin.