Testing dialysis patients for blood borne viruses

As a dialysis patient you need to be aware of changes in testing procedures for blood borne viruses.

This leaflet is intended to explain what these viruses are, why testing is carried out and what your rights are.

What are blood borne viruses?

A blood borne virus is any virus that is spread through contact with the blood of an infected person. In dialysis, with the potential for exposure to other people’s blood, prevention of cross-infection is the highest priority. Other body fluids from patients who carry those viruses may also be infectious. These include urine and peritoneal dialysis fluid.

There are 3 viruses that need to be guarded against: hepatitis B, hepatitis C and human immunodeficiency virus (HIV).

What can be done to stop cross infection?

Both patients and hospital staff need to be protected against possible cross-infection (person to person spread) by these viruses. There are two ways that transmission can be prevented:

1. By using ‘universal precautions’. This includes proper handwashing, wearing gloves and aprons when contact with any bodily fluid is anticipated and dealing with any spillages in the correct manner. All areas also practice proper disposal of sharps and equipment, machine cleaning procedures.

2. By testing patients for these viruses to identify carriers of the virus. In this way carriers may be segregated for dialysis purposes reducing the risk of further cross-infection.

How often will testing be carried out?

In 1997, the Standards Subcommittee of the Renal Association produced guidelines on the testing of patients for these viruses. They recommend the following testing intervals for peritoneal dialysis and haemodialysis patients:

Hepatitis B every 3 months

Hepatitis C every 6 months

HIV annually

The Nephrology & Transplant Directorate at UHW is implementing these recommendations.

What rights do I have?

  • You will be asked for your verbal consent for testing for these viruses by your doctor.
  • You have the right to decline any or all of the blood tests.
  • If you wish, counselling will be provided prior to any testing for HIV.
  • If you decline testing you will not be declined dialysis. However, for the purpose of protecting others, all patients who decline testing will need extra precautions to be taken during their dialysis.

Will testing take place at other times?

All new patients entering the End-Stage Renal Failure programme will be tested on commencement for all the above viruses.

All transplant patients will be tested immediately prior to and six months after transplant for the above viruses.

What happens if a patient is positive for any virus

In the very unlikely event of anyone being found positive, arrangements will be made for the patient to be seen by the Infectious Disease Consultant to determine if any treatment is necessary. Counselling, support and advice will be provided by our Dialysis Co-ordinator.

Any infected individual who requires dialysis will continue to receive their treatment without interruption. However, precautions will be taken to prevent the spread of the virus as outlined above.

Finally, advice will be given to any patient who is found to be positive to one of these viruses on aspects of daily living to prevent spread to anyone else at home or at work.

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