J Cardiovasc Med (Hagerstown)
January 2012
Background: A deterministic mathematical model is developed to explain nontransfusion nosocomial transmission of hepatitis C virus (HCV) from patient to patient during hemodialysis sessions.
Methods: The model requires 4 sequential steps for cross-transmission: (1) The dialysis session contains at least 1 patient infected with HCV; (2) a hemodialysis staff member connects an uninfected patient to dialysis after having connected an infected patient; (3) the hemodialysis staff member does not change gloves between an infected patient and an uninfected patient; and (4) the uninfected patient is contaminated after exposure to the blood of an infected patient.
Results: We tested the model by comparing observed incidences of HCV infection from epidemiologic studies with calculated incidences.
A 75-year-old man with splenic marginal zone lymphoma had been treated by fludarabine. The 3 first courses were very well tolerated, with no cytopenia. To treat diabetes mellitus, metformin was added at day 6 after the beginning of the fourth course of fludarabine treatment.
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