What is the difference between hemodialysis and hepatitis C infection?

  Long-term regular hemodialysis is one of the major renal replacement therapies for end-stage renal disease uremia, and hemodialysis can sustain and prolong the life of uremic patients. Of course, hemodialysis patients can only achieve a relatively high quality long-term survival close to that of the normal population with good compliance, support from health insurance payments and support and understanding from society and family.  Uremia is a syndrome of renal-based decompensation or failure of one or more systems and organs, and most people in this group have nutritional disorders, damage and defects in hematopoietic and immune system functions. Since hemodialysis is an open treatment of the blood system, patients receiving long-term hemodialysis replacement therapy are at a much higher risk of developing infectious diseases, including hepatitis B and C, which are mainly transmitted through blood sources. Both nationally and internationally, patients are routinely informed of such risks prior to receiving hemodialysis.  Both nationally and internationally, the positive rate of hepatitis C transmissions in the long-term hemodialysis population is much higher than in those with other infectious diseases or receiving other in-hospital or out-of-hospital treatments. Even in developed Western countries, many researchers have reported that neither the provision of special equipment for hepatitis C-infected patients nor the establishment of isolation wards have prevented hepatitis C infection or positive transfer rates in long-term hemodialysis patients, and that there is an increase with the age of dialysis. In developed countries such as Europe and the United States, the positive rate of hepatitis C transmission in long-term hemodialysis patients may even reach 7-8% or higher. Since the “window period” for hepatitis C infection can be as long as six months or more than a year, this can also lead to incomplete isolation of patients with hepatitis C infection.  At present, domestic and international observations have shown that the long-term hemodialysis population has a high susceptibility to hepatitis C. Specific susceptibility factors are still being studied and analyzed. Isolation of hepatitis C-infected patients is also not currently strongly recommended in developed countries as a method of preventing blood-borne pathogens through strict implementation of infection control measures.  Some prospective observational studies have reported that it is possible to reduce the rate of hepatitis C infection in hemodialysis patients with enhanced basic hygiene protection, as long as infection control measures are strictly adhered to and implemented in hemodialysis units to prevent transmission of pathogens through the bloodstream. These include, among others, education programs for healthcare workers and patients, hand hygiene, maintenance and disinfection of dialysis machines, and management of medical items and waste. Implementation of strict regulatory practices can, to some extent, reduce the positive rate of hepatitis C transmissions in long-term hemodialysis populations.  For testing of hepatitis C, if only antibody is positive, it is generally regarded as the result of infection only; positive nucleic acid of hepatitis C virus can confirm the diagnosis of a person with current hepatitis C infection. There is a mature and standardized treatment process for hepatitis C, and a treatment plan with better efficacy is available for those with current infection.