Abstract
Hepatitis C virus (HCV) infection is a significant problem among haemodialysis populations worldwide. 'Horizontal' cross-infection between patients can occur, predominately through direct environmental transmission of the virus. Current guidelines thus recommend universal barrier precautions, however they do not suggest using dedicated machines for HCV-positive patients to prevent the 'sequential' transmission of virus to those who subsequently use that machine. We report a case where sequential HCV transmission occurred from a patient of low HCV infectivity with no identifiable machine fault. We suggest that current guidelines should be reviewed to encourage the use of dedicated haemodialysis machines for HCV-positive patients.