Question

Hepatitis C is a chronic liver infection that can be either silent (with no noticeable symptoms) or debilitating. Either way, 80% of infected persons experience continuing liver destruction. Chronic hepatitis C infection is the leading cause of liver transplants in the United States. The virus that causes it is blood borne, and therefore patients who undergo frequent procedures involving transfer of blood are particularly susceptible to infection. Kidney dialysis patients belong to this group. In 2008, a for-profit hemodialysis facility in New York was shut down after nine of its patients were confirmed as having become infected with hepatitis C while undergoing hemodialysis treatments there between 2001 and 2008.

When the investigation was conducted in 2008, investigators found that 20 of the facility’s 162 patients had been documented with hepatitis C infection at the time they began their association with the clinic. All the current patients were then offered hepatitis C testing, to determine how many had acquired hepatitis C during the time they were receiving treatment at the clinic. They were considered positive if enzyme-linked immunosorbent assay (ELISA) tests showed the presence of antibodies to the hepatitis C virus.

Health officials did not test the workers at the hemodialysis facility for hepatitis C because they did not view them as likely sources of the nine new infections. Why not?

Why do you think patients were tested for antibody to the virus instead of for the presence of the virus itself

Answer 1

Hepatitis C is a RNA virus which causes hepatitis and hepatocarcinoma in long term.

Health officials did not test the workers at the hemodialysis facility for Hepatitis C because, this virus does not spread by air, food or water or throug contact. It spreads by blood transfusion and sexual intercourse. Since the dialysis is a procedure where blood is passed through dailysis machine where there is a chance of mixing/contamination of blood of one patient with other, it would be the most likely cause of spread of infection.

The patients were tested for antibody instead of the virus itself because, antibodies persist in the blood even after the infection has subsided. Since the investigation was done years after the incident, it is more rpactical to test for antibodies than to virus. There may n ot be virus in a person who is treated with antiviral drugs. But, the antibodies persist for decades even after the infection is cured.