Beaumont Hospital has recorded what appears to be its first case of hepatitis C in a patient undergoing dialysis, The Irish Times has learned.
The discovery was made earlier this summer. It is believed to be the first such case in the Republic. Hepatitis C is a viral infection of the liver, which can be transmitted by blood transfusion, intravenous drug use and by sexual contact.
It is estimated to affect 1.5 to 2 per cent of the population in the Western world.
The newly diagnosed hepatitis C case, in the renal dialysis unit of Beaumont Hospital, one of the State's principal centres for the treatment of chronic kidney disease, was discovered as part of a routine three-monthly screening of all 146 patients who are receiving treatment at the unit.
Hospital authorities will not confirm details of the patient's age or sex, citing patient confidentiality. However, it is understood that a blood source, sexual transmission and drug abuse have been firmly ruled out as the method of infection.
Some 142 of the unit's patients have tested negative for hepatitis C. Three patients were known to have hepatitis C before they commenced dialysis. The remaining patient is understood to have had no trace of the viral infection early this year, but tested positive for hepatitis C on routine screening during the summer.
According to Dr Edmond Smyth, a consultant microbiologist in Beaumont, "the risk to other patients is minimal". He confirmed that dialysis equipment at the hospital was decontaminated between each patient according to rigorous international protocol. All patients are now undergoing further screening in an effort to further define their infection-free status. The hospital also confirmed that the issue of closing the dialysis unit did not arise in view of the minimal risk of infection to other patients.
The Irish Times understands that patients are told of the theoretical risk of hepatitis infection before they consent to dialysis. All of those currently undergoing dialysis at Beaumont Hospital are being informed of the recent finding.
International statistics show a high prevalence of hepatitis C amongst dialysis patients in some countries. In Italy, dialysis units report a 30 per cent prevalence of hepatitis C. Some centres in the United States have a seroprevalence of 40 per cent.
Having ruled out blood transfusion, intravenous drug use and sexual transmission in this patient, the possibility of infection by dialysis remains. However, a failure of strict procedures, including both staff and machinery, would have to occur for the patient to be infected in this way.
The vast majority of potential blood donors found to be carrying hepatitis C have no identifiable risk factors and the source of infection remains a mystery. At this point in the investigation the Beaumont patient falls into this "unknown" category.
The Beaumont dialysis unit carries out 21,000 treatments every year. It operates on a 24-hour basis, with many of its 146 patients requiring lengthy dialysis sessions on a number of days per week. Dialysis is carried out on patients with kidney failure. The treatment removes toxic products from the bloodstream. Without dialysis, renal failure can be fatal.
Renal failure is caused by a number of diseases including diabetes and high blood pressure. Inflammation of the kidney cells (glomerulonephritis) - which can result from infection - is a less common cause of chronic kidney failure. Kidney stones rarely cause this condition. When kidneys fail, a substance called urea builds up in the blood causing extreme tiredness and urinary symptoms.