Seroprevalence occurrence of viral hepatitis and HIV among hemodialysis patients

Seroprevalence and risk factors of HBV, HCV and HIV among hemodialysis patients: a multicenter cross-sectional study from Damascus Syria

OBJECTIVE

The aim of this study is to determine the prevalence rates of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections among hemodialysis (HD) patients as well as to identify associated risk factors.

METHODOLOGY

A multicenter cross-sectional study involved patients who had been on HD for at least three months. The study was conducted at five HD centers in Damascus, Syria from August 2019 to September 2021. HBsAg, HCV-Ab and HIV (antibody/antigen) seropositivity were identified using the third generation ELISA technique. Patients' information was extracted from their records and by face-to-face interview. Multiple logistic regression models were applied to identify risk factors associated with HBV or HCV seropositivity. The significance level was set at 5%.

RESULTS

A total of 637 patients were included in the study with a mean age (SD) of 50.5 (15.6) years and 56.7% of them were men. The dialytic age ranged from one to thirty years with a mean (SD) of 6.10 (5.6) years. The prevalence of positive hepatitis B surface antigen, anti-HCV, co-infection of HBV and HCV, and anti-HIV (antibody/antigen) were 3.2%, 22.1%, 0.7%, and 0%, respectively. After controlling for co-variables, hepatitis B vaccine was the only predictor of seropositivity of HBV (OR: 0.15, 95% CI: 0.057-0.393, P < 0.001), as it significantly protected against contracting HBV. On the other hand, the dialytic age (OR: 1.42, 95% CI: 1.12-1.94, P = 0.032) and the dialysis center were significant factors affecting the prevalence of HCV.

CONCLUSIONS

The prevalence of HCV and HBV infections among HD patients in Damascus, Syria has decreased remarkably compared with the results from 2001. Nevertheless, it is still considered relatively high. Thus, there is an urgent need to strengthen the prevention and control measures for viral infection transmission in HD centers in Damascus.

Prevalence of HBV, HCV, and HIV Infections among Patients Undergoing Hemodialysis in Fasa, Iran: A Six-Year Follow-up Study

Background: Hemodialysis (HD) patients are at risk of viral infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency viruses (HIV). Current study aimed to determine the prevalence of HBV, HCV, and HIV among HD patients who attended the dialysis center in Fasa, Iran. Methods: Collectively, 2082 HD patients (1291 men, 791 women) took part in our 6-year follow-up study. Results: 2082 HD patients with a mean age of 56.2±17.8 were included in our study. One (0.09%) patient was HBsAg positive, two (0.18%) patients were anti-HCV positive, and one (0.09%) was anti-HIV positive. There was no significant correlation between the paraclinical parameters of men and women. Conclusion: The present study showed a reduction in the prevalence of HBV, HCV, and HIV infections during 6 years of follow-up in HD patients.

Arteriovenous fistula takedown in hemodialysis patients: our experience of 26 cases

Introduction

Creation of arteriovenous fistulas (AVF) for providing vascular access in patients dependent on hemodialysis is a very frequent type of surgery. One of the common complications of such a fistula is the formation of an aneurysm or a pseudoaneurysm and the risk of impending rupture. These are a few of the reasons why such surgically created AVF have to be taken down surgically. Some of these may be taken down for cosmetic reasons electively while some present in an emergency due to rupture of the aneurysm itself.

Aim

This is a retrospective study of 26 patients who underwent AVF takedown at our center over a period of 4 years.

Material and methods

We intended to study the patient profile, the surgery that they underwent and the post-operative course of these patients.

Results

We found that aneurysm formation was the most common reason for a takedown, although we did see a good percentage of patients who presented to us with a ruptured AVF aneurysm. Our procedure was a ligation of the aneurysm with resection of the aneurysmal segment and maintaining arterial continuity. No attempt to preserve the fistula was made in any of these cases.

Conclusions

This article gives a brief overview of our experience in AVF takedown.

Profile and predictors of hepatitis and HIV infection in patients on hemodialysis of Quetta, Pakistan

Hemodialysis (HD) is the most commonly used treatment in patients with end-stage renal failure or disease (ESRD) worldwide. Blood-borne viral diseases are the major causes of mortality and morbidity in patients on HD. This study aims to analyze the prevalence and to concentrate on the key risk factors that are responsible for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection in patients on HD visiting two dialysis centers in the city of Quetta in southwestern Pakistan. The overall incidence of HBV was found to be 16.1%, the overall incidence of HCV was found to be 43.2%, and two patients (1.6%) were found to be positive for both HBV and HCV. HIV was not found among patients seen at both hospitals during the study period. The main risk factors for development of a viral infection were the length of time on HD (p = 0.007), number of sessions (p = 0.001), and level of education (p = 0.092). Biochemical and hematological parameters including urea, creatinine, uric acid, and calcium levels, red blood cell count, white blood cell count, hemoglobin levels, and platelet count were also studied in patients on HD. HD is becoming one of the major factors causing a viral infection because a patient can possibly become infected during an HD session via a blood transfusion, dialysis machines, instruments and/or other contaminated equipment. In order to control the spread of viral infections, increased public awareness, vaccinations, and health education programs for both health care providers and patients are needed, and proper screening programs should be instituted before dialysis is performed.