Uma experiência exitosa com portadores de Hepatite C em unidades de hemodiálise contribuindo para a microeliminaçâo da infecção

Abstract

INTRODUCTION: Chronic Hepatitis C Virus (HCV) infection is a major cause of death and represents one of the main challenges to public health globally, with uneven prevalence across countries. Estimates show that around 71 million patients are infected with HCV worldwide. Hepatitis C is one of the leading causes of liver-related comorbidities, deaths and transplants. It is predominantly parenterally transmitted, favoring an important prevalence in hemodialysis services. HCV infection increases morbidity and mortality among individuals on Renal Replacement Therapy (RRT), and is therefore considered a priority group for the elimination of hepatitis C in the projections of the World Health Organization (WHO), effectively requiring strategies that facilitate its elimination in the Dialysis Units (DUs). OBJECTIVE: To develop a flowchart for diagnosing, evaluating and referring patients with HCV to treatment in three dialysis units in a capital in northeastern Brazil. METHODOLOGY: This is a descriptive study, of the experience report type, which detailed the use of a flow from the identification, diagnosis and referral for treatment of HCV carriers in DUs in the city of São Luís (MA). The population consisted of 925 patients on dialysis therapy, 25 patients with reactive anti-HCV serology comprised the sample as suspected carriers of hepatitis C, all patients, both genders, who had reactive anti-HCV during the collection period were selected for the study. Data collection was carried out from August 2021 to June 2022. RESULTS: With the flowchart used, through the Nursing Process (NP) 25 patients on dialysis (2.7%) with anti - HCV reagent were identified, of which 21 were male (84%), 17 aged between 20 to 64 years old (68%), with a mean age of 57 years old, 10 referred arterial hypertension as the main cause of CKD (40%), followed by 9 patients who referred arterial hypertension associated with diabetes as the second cause of the complication( 36%), 15 had 1 to 10 years of dialysis time (60%), with an average dialysis time of 8 years, 16 had 1 to 10 years (64%) , with an average of 5 years of anti-test time – Reactive HCV. With the NP it was possible to organize nursing care for diagnosis and referral for HCV treatment in the DUs. Infection was confirmed in 17 patients (68%), of which 15 were referred for treatment (88.23%), through the NP care plan, to the nephrologists who assist them in the DUs, without the need for them to travel to a specialized laboratory or clinic. CONCLUSION: The experience carried out with the flowchart is proven to be feasible in the identification, diagnosis and treatment of HCV carriers, with a treatment scheme with effective antivirals, free of charge and with the convenience of the patient being treated by the nephrologist within the DUs, contributing to the elimination of infection in patients on RRT.