From Seroprevalence Data to Clinical Action: Enhancing HCV Micro-Elimination Protocols in Hemodialysis Units through Molecular Surveillance

Author : Rounaq Rasool

Abstract : Background: Hepatitis C virus (HCV) infection remains a major nosocomial concern in hemodialysis (HD) units, particularly in lowand middle-income settings. Patients on long-term hemodialysis are at increased risk due to repeated vascular access, blood transfusions, and prolonged healthcare exposure. Achieving HCV micro-elimination in HD units requires integration of serological screening with molecular surveillance to enable early detection and timely clinical intervention. Objectives: To determine the seroprevalence of HCV infection, assess HCV RNA positivity and genotype distribution, and translate these findings into actionable strategies for strengthening HCV micro-elimination protocols in hemodialysis units. Materials and Methods: This cross-sectional observational study was conducted among chronic hemodialysis patients at a tertiary care hospital in Udaipur, Rajasthan. Patients were screened for anti-HCV antibodies using third-generation ELISA, with periodic follow-up for seroconversion. All antibody-positive samples and pooled antibody-negative samples were subjected to real-time RTPCR for HCV RNA detection and genotyping. Demographic data, dialysis duration, comorbidities, transfusion history, and infectioncontrol practices were analyzed. Results: Anti-HCV antibodies were detected in 35.86% of patients, while 22.07% were confirmed HCV RNA-positive, highlighting a significant discrepancy between serological and molecular detection. Prolonged duration of hemodialysis showed a strong association with both seropositivity and RNA positivity (p < 0.01). Genotype analysis revealed HCV subtype 1a as the predominant strain (87.5%), followed by genotype 3b. These findings indicate ongoing silent transmission within dialysis settings and emphasize the limitations of antibody-only screening strategies. Conclusion: The study underscores the critical role of molecular surveillance alongside routine serology for early identification of active HCV infection in hemodialysis units. Incorporation of RT-PCR–based screening, strict infection-control adherence, and genotype-guided antiviral therapy can significantly enhance HCV micro-elimination efforts. Translating seroprevalence data into targeted clinical action is essential to achieving sustained HCV elimination in high-risk dialysis populations

Keywords : Hepatitis C Micro-Elimination in Hemodialysis Units: Integrating Serological and Molecular Surveillance in a Tertiary Care Setting

Conference Name : International Conference on Infectious Diseases, Immunology and Translational Medicine (ICIDITM-26)

Conference Place : Delhi, India

Conference Date : 10th Jan 2026