Hepatitis B (HBV) and hepatitis C (HCV) viruses are the most important causes of chronic liver disease in patients with end stage renal disease on hemodialysis. The prevalence of hepatitis infection among hemodialysis patients is high and varies between countries and between dialysis units within a single country. This case-control study was undertaken to estimate the occurrence of HBV and HCV infections in patients undergoing hemodialysis in our tertiary care center. All patients receving hemodialysis at our centre with HCV or HBV infection were included in the study. The total number of patients admitted for hemodialysis during the study period was 1710. Among these, 26 patients were positive for HBV, 19 were positive for HCV, and 2 were positive for both HCV and HBV. Mean age of the infected cases in our study was 48.63 years. Mean duration of dialysis for infected cases was 4.8 years while that of the noninfected controls was 3.18 years. The mean dialysis interval was twice a week. Interventions to reduce the occurrence of these infections are of utmost need to reduce the risk of long-term complications among hemodialysis patients. 1. Introduction Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections cause morbidity and mortality in haemodialysis patients. Prolonged vascular exposure and multiple blood transfusions increase the risk of acquiring these blood-borne infections in these patients. Contaminated devices, equipments, and supplies, environmental surfaces, and attending personnel may also play a crucial role in the nosocomial transmission of these infections. Infections with hepatitis viruses in haemodialysis patients are further promoted by the significant immune status dysfunction developing due to irreversible renal compromise [1–3]. Furthermore, hepatitis viral infections in haemodialysis patients cause liver disease in renal failure patients undergoing replacement therapy. They also pose a significant problem in the management of these cases as patients with renal failure cannot clear the viruses effectively. Patients with coinfections with these viruses develop severe clinical presentations and resistance to interferon treatment [3]. There are very limited data available on the occurrence of such infections in haemodialysis patients from this part of the country. The present study aimed to investigate the occurrence of HBV and HCV infections in haemodialysis patients and the risk factors associated with such infections. 2. Materials and Methods This study was conducted as a retrospective case-control study involving the
References
[1]
J. Q. Abumwais and O. F. Idris, “Prevalence of hepatitis C, hepatitis B, and HIV infection among haemodialysis patients in Jenin District (Palestine),” Iranian Journal of Virology, vol. 4, no. 2, pp. 38–44, 2010.
[2]
P. Bhaumik and K. Debnath, “Prevalence of hepatitis B and C among haemodialysis patients of Tripura, India,” Euroasian Journal of Hepato-Gastroenterology, vol. 2, no. 1, pp. 10–13, 2012.
[3]
G. A. Reddy, K. V. Dakshinamurthy, P. Neelaprasad, T. Gangadhar, and V. Lakshmi, “Prevalence of HBV and HCV dual infection in patients on haemodialysis,” Indian Journal of Medical Microbiology, vol. 23, no. 1, pp. 41–43, 2005.
[4]
A. Aghakhani, M. Banifazl, A. Eslamifar, F. Ahmadi, and A. Ramezani, “Viral hepatitis and HIV infection in hemodialysis patients,” Hepatitis Monthly, vol. 12, no. 7, pp. 463–464, 2012.
[5]
A. E. O. Otedo, S. O. Mc'Ligeyo, F. A. Okoth, and J. K. Kayima, “Seroprevalence of hepatitis B and C in maintenance dialysis in a public hospital in a developing country,” South African Medical Journal, vol. 93, no. 5, pp. 380–384, 2003.
[6]
S. U. Busek, E. H. Babá, H. A. Tavares Filho et al., “Hepatitis C and hepatitis B virus infection in different hemodialysis units in Belo Horizonte, Minas Gerais, Brazil,” Memorias do Instituto Oswaldo Cruz, vol. 97, no. 6, pp. 775–778, 2002.
[7]
S. K. Agarwal, S. C. Dash, and M. Irshad, “Hepatitis C virus infection during haemodialysis in India,” Journal of Association of Physicians of India, vol. 47, no. 12, pp. 1139–1143, 1999.
[8]
A. Chowdhury, A. Santra, R. Chakravorty et al., “Community-based epidemiology of hepatitis B virus infection in West Bengal, India: prevalence of hepatitis B e antigen-negative infection and associated viral variants,” Journal of Gastroenterology and Hepatology, vol. 20, no. 11, pp. 1712–1720, 2005.
[9]
D. Saha and S. K. Agarwal, “Hepatitis and HIV infection during haemodialysis,” Journal of the Indian Medical Association, vol. 99, no. 4, pp. 194–199, 2001.
[10]
M. Espinosa, A. Martín-Malo, R. Ojeda et al., “Marked reduction in the prevalence of hepatitis C virus infection in hemodialysis patients: causes and consequences,” American Journal of Kidney Diseases, vol. 43, no. 4, pp. 685–689, 2004.
[11]
M. A. S. Carneiro, S. A. Teles, M. A. Dias et al., “Decline of hepatitis C infection in hemodialysis patients in Central Brazil: a ten years of surveillance,” Memorias do Instituto Oswaldo Cruz, vol. 100, no. 4, pp. 345–349, 2005.
[12]
K. Kosaraju, S. Padukone, and I. Bairy, “Co-infection with hepatitis viruses among HIV-infected individuals at a tertiary care centre in South India,” Tropical Doctor, vol. 41, no. 3, pp. 170–171, 2011.
[13]
J. Tourret, I. Tostivint, S. T. du Montcel, et al., “Outcome and prognosis factors in HIV-infected haemodialysis patients,” Clinical Journal of the American Society of Nephrology, vol. 1, no. 6, pp. 1241–1247, 2006.
[14]
M. Chandra, M. N. Khaja, M. M. Hussain et al., “Prevalence of hepatitis B and hepatitis C viral infections in Indian patients with chronic renal failure,” Intervirology, vol. 47, no. 6, pp. 374–376, 2004.
[15]
M. J. Zahedi, S. D. Moghaddam, S. M. Alavian, and M. Dalili, “Seroprevalence of hepatitis viruses B, C, D and HIV infection among hemodialysis patients in Kerman Province, South-East Iran,” Hepatitis Monthly, vol. 12, no. 5, pp. 339–343, 2012.
[16]
A. Covic, L. Iancu, C. Apetrei et al., “Hepatitis virus infection in haemodialysis patients from Moldavia,” Nephrology Dialysis Transplantation, vol. 14, no. 1, pp. 40–45, 1999.
[17]
D. N. Irish, C. Blake, J. Christophers, et al., “Identification of hepatitis C virus seroconversion resulting from nosocomial transmission on a haemodialysis unit: implications for infection control and laboratory screening,” Journal of Medical Virology, vol. 59, no. 2, pp. 135–140, 1999.
[18]
A. E. Y. El-Ottol, A. A. Elmanama, and B. M. Ayesh, “Prevalence and risk factors of hepatitis B and C viruses among haemodialysis patients in Gaza strip, Palestine,” Virology Journal, vol. 7, p. 210, 2010.
[19]
A. A. A. Sabry, K. F. El-Dahshan, K. M. Mahmoud, and A. A. El-Husseini, “Effect of HCV infection on hematocrit and hemoglobin level in Egyptian hemodialysis patients,” International Urology and Nephrology, vol. 41, no. 1, pp. 189–193, 2009.
[20]
K. A. Alsaran, A. A. Sabry, A. H. Alghareeb, and G. Al Sadoon, “Effect of hepatitis C virus on hemoglobin and hematocrit levels in Saudi hemodialysis patients,” Renal Failure, vol. 31, no. 5, pp. 349–354, 2009.
[21]
Y. L. Lin, C. W. Lin, C. H. Lee, I. C. Lai, H. H. Chen, and T. W. Chen, “Chronic hepatitis ameliorates anaemia in haemodialysis patients,” Nephrology, vol. 13, no. 4, pp. 289–293, 2008.
[22]
M. Radovic, W. Jelkmann, L. Djukanovic, and V. Ostric, “Serum erythropoietin and interleukin-6 levels in hemodialysis patients with hepatitis virus infection,” Journal of Interferon and Cytokine Research, vol. 19, no. 4, pp. 369–373, 1999.
