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Hepatitis Type A and Hemodialysis: A Seroepidemiologic Study in 15 U.S. Centers

WOLF SZMUNESS, M.D.; JULES L. DIENSTAG, M.D.; ROBERT H. PURCELL, M.D.; ALFRED M. PRINCE, M.D.; CLADD E. STEVENS, M.D.; and RICHARD W. LEVINE
[+] Article and Author Information

Grant support: Grant No. HL-09011-13 and Contract No. C2101-201 from the National Heart and Lung Institute, National Institutes of Health; Bethesda, Maryland.

▸Requests for reprints should be addressed to Wolf Szmuness, M.D.; Laboratory of Epidemiology, New York Blood Center; 310 East 67 Street; New York, NY 10021.


New York, New York


Ann Intern Med. 1977;87(1):8-12. doi:10.7326/0003-4819-87-1-8
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Four hundred sixty patients and staff from 15 U.S. dialysis centers were surveyed by the immune adherence hemagglutination technique for antibody to hepatitis A antigen (anti-HA). The age-standardized anti-HA prevalence was 42.9% in patients and 42.1% in staff. These rates are almost identical to those of socioeconomically comparable urban volunteer blood donors never exposed to dialysis settings. There was no correlation between anti-HA prevalences and duration of dialysis treatment or employment. Among 100 patients and staff followed for 1 year 92% to 94% did not change their anti-HA status. The prevalence of anti-HA was identical in subjects with past histories of multiple blood transfusions or accidental inoculations with blood-contaminated instruments and in those without such histories. We conclude that hepatitis A virus rarely if ever spreads by parenteral mechanisms, that there is no epidemiologic evidence confirming the existence of chronic hepatitis A viremic carrier states, and that hemodialysis does not play a significant role in the spread of type A hepatitis.

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