Control of hepatitis B infection. The role of surveillance and an isolation hemodialysis center

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Abstract
A 3 1/4 yr study assessed intervention approaches for hemodialysis-associated hepatitis. A 12 mo. retrospective study was followed by 1 yr of prospective surveillance (during which attention to hygienic techniques was encouraged) and then by a 15 mo. period during which antigen-positive cases were transferred from study centers to an isolation hemodialysis center (IHC). The incidence of hepatitis B infection (HBI) fell 35.9% in study centers during surveillance; this was followed by a 50.0% drop during the IHC phase. The total 67.9% drop during the entire study period was statistically highly significant; the IHC contributed significantly more to the total drop than did surveillance alone. At comparison units, HBI increased 97.9% during the same period. Thus HBI incidence can be markedly reduced by a combination of surveillance and assignment of antigen-positive patients to a separate dialysis unit.

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