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The Role of Surveillance and an Isolation Hemodialysis Center

G. Reza Najem, MD, PhD; Donald B. Louria, MD; Inderjit S. Thind, MD, DrPH; Marvin A. Lavenhar, PhD; David J. Gocke, MD; Stuart E. Baskin, MD; Ann Marie Miller; Howard J. Frankel, MD; Joel Notkin, MD; Martin G. acobs, MD; Barry Weiner, MD

JAMA. 1981;245(2):153-157.

Abstract
A 3-year study assessed intervention approaches for hemodialysis-associated hepatitis. A 12-month retrospective study was followed by one year of prospective surveillance (during which attention to hygienic techniques was encouraged) and then by a 15-month period during which antigen-positive cases were transferred from study centers to an isolation hemodialysis center (IHC). The incidence of hepatitis B infection (HBI) fell 35.9% in study centers during surveillance; this was followed by a 50.0% drop during the IHC phase. The total 67.9% drop during the entire study period was statistically highly significant; the IHC contributed significantly more to the total drop than did surveillance alone. At comparison units, HBI increased 97.9% during the same period. This study indicates that HBI incidence can be markedly reduced by a combination of surveillance and assignment of antigen-positive patients to a separate dialysis unit.

(JAMA 1981;245:153-157)

Author Affiliations
From the Department of Preventive Medicine and Community Health, College of Medicine and Dentistry of New Jersey, Newark (Drs Najem, Louria, Thind, Lavenhar, and Baskin, and Ms Miller); Rutgers Medical School, Piscataway, NJ (Dr Gocke); East Orange (NJ) General Hospital (Dr Frankel); Dialysis Centers of Biomedical Life Support Systems, Pine Brook, NJ (Dr Notkin); St Barnabas Hospital, Livingston, NJ (Dr Jacob); and Jersey City (NJ) Medical Center (Dr Weiner).

Footnotes
Presented in part at the 12th Annual Meeting of the Society for Epidemiological Research, New Haven, Conn, June 14, 1979.

Reprint requests to Department of Preventive Medicine, College of Medicine and Dentistry of New Jersey, New Jersey Medical School, 100 Bergen St, Newark, NJ 07103 (Dr Najem).

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