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AYDIN Ö, ERGEN P, ERBAKAN AN, ALIŞIR EJDER S. Overview of blood-borne viral infections in hemodialysis patients: hepatitis B, hepatitis C, human immunodeficiency virus infections. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.991215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Jindal N, Goyal LD, Singh C. Sociodemographic features associated with Hepatitis C Virus (HCV) in pregnant females: A tertiary care centre study from Malwa region of Punjab (North India). J Family Med Prim Care 2021; 10:2679-2683. [PMID: 34568154 PMCID: PMC8415663 DOI: 10.4103/jfmpc.jfmpc_2372_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 12/12/2022] Open
Abstract
Background Hepatitis C virus (HCV) infection is high in state of Punjab, however very few studies have been done till date. We all know that pregnant females are a most important section of our community and are usually screened for HCV, HIV, and Hepatitis B at time of presentation. HCV is capable of causing chronic infections and having long-term implications on a person's health. Vertical transmission of HCV can be one of the major route of transmission of this virus to the neonate and there have been various sociodemographic factors like age, literacy, socioeconomic status, occupational status, associated with the disease causation and transmission. Methods All pregnant females attending Obstetrics and gynecology department of our institute were included in study. All the sociodemographic characters and socioeconomic records were retrieved and analyzed. Results In our study also a lower socioeconomic status, illiteracy have been significantly associated with the HCV-positive group, thus emphasizing the role of education so as to impart education to the masses as regard to mode of transmission and its effects on the disease. Higher age of conceiving is also significant associated with the increased maternal risk. Conclusions The more involvement of health care officials and even persons not related to health care set up is required who can educate masses so as to protect the community.
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Affiliation(s)
- Neerja Jindal
- Department of Microbiology, GGS Medical College and Hospital, Faridkot, Punjab, India
| | - Lajya D Goyal
- Department of Obstetrics and Gynaecology, AIIMS, Bathinda, Punjab, India
| | - Charu Singh
- Department of Microbiology, IMS BHU, Varanasi, Uttar Pradesh, India
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Bayani M, Hasanjani Roushan MR, Soleimani Amiri MJ, Yahyapour Y, Ebrahimpour S, Akbarzadeh Jelodar S. Prevalence of occult hepatitis C virus infection in hemodialysis patients. CASPIAN JOURNAL OF INTERNAL MEDICINE 2021; 12:533-538. [PMID: 34820059 PMCID: PMC8590405 DOI: 10.22088/cjim.12.4.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/02/2020] [Accepted: 12/06/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Via hemodialysis, viral infections can be transmitted in patients a new definition of this infection with no increase in liver enzymes, negative HCV-PCR in serum and presence of virus in the liver and peripheral blood mononuclear cell (PBMC) called occult hepatitis C virus (HCV) infection (OCI). We decided to examine the prevalence of occult hepatitis C infection on hemodialysis cases. METHODS The current research is a cross-sectional study on patients with end-stage renal disease (ESRD) who were at three hemodialysis centers in Mazandaran province in Iran during 2012-2014. In this study of 356 patients who were undergoing hemodialysis, 54 patients were excluded due to positive HCV Ab, and the remaining 302 patients were enrolled. The test of all serum samples for HCV-RNA detection of plasma and PBMCs was done by real-time polymerase chain reaction (real-time PCR). RESULTS There was a significant association between the duration of dialysis with the prevalence of occult HCV infection (P=0.017). Eight (2.65%) patients were positive for HBs Ag and with OCI, but none of them was infected with both hepatitis C and B obviously. Also among the total number of patients, nine patients tested positive for HCV RT-PCR in PBMC in which one of them was positive for serum HCV RNA PCR and was excluded from the study. CONCLUSION The results showed that eight patients had an OCI. There was not any association found between age and sex with OCI, but there was a significant relationship between the duration of dialysis with the prevalence of OCI.
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Affiliation(s)
- Masomeh Bayani
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Reza Hasanjani Roushan
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Jafar Soleimani Amiri
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Yousef Yahyapour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Somayeh Akbarzadeh Jelodar
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran,Correspondence: Somayeh Akbarzadeh Jelodar, Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. E-mail: , Tel: 0098 1132207918, Fax: 0098 1132207918
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Ahmed AMA, Temerk HA, Galal HR, Bazeed SES, Sultan S. The seropervelance of infectious hepatitis viruses (HBV, HCV and HEV) among blood donors and their correlation to risk factors in Qena governorate, Upper Egypt. Virusdisease 2020; 31:292-298. [PMID: 32904769 DOI: 10.1007/s13337-020-00589-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/24/2020] [Indexed: 12/13/2022] Open
Abstract
This study was performed to determine the prevalence of HBV and HCV infection among blood donors and the occurrence of HEV in hepatitis viruses seropositive blood donors. Also, to investigate the correlation between the occurrence of hepatitis viruses and other risk factors (gender, age, occupation, educational level, residency and donors' types). A total of 11,604 blood samples from apparently healthy blood donors of age range 18-60 years old were collected. The blood donors were categorized as voluntary and replacement donors. Blood samples from donors were tested for the presence of HBsAg, HCV and HEV antibodies by using Enzyme-linked immunosorbent assay. The overall results indicated that 671 out of 11,604 blood donors; 370 persons (3.188%) HCV, 295 persons (2.542%) HBV and 6 persons (0.052%) HCV and HBV; were hepatitis viruses seropositive donors. The prevalence of HEV were 193 (28.76%) among these seropositive blood donors. There is a highly significant correlation among HCV, HBV and other risk factors. Also, the HEV showed high significant with age and educational level and significant with donor types and locations. All investigated virus combinations (HEV/HCV, HEV/HBV and HEV/HCV/HBV) were highly significant with the risk factors except for occupation. In conclusion, the HEV is significantly correlated to HCV and HBV seropositive donors and should be screened among blood donors.
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Affiliation(s)
- Azza Masoud Abdelbaky Ahmed
- Department of Microbiology, Virology Division, Faculty of Veterinary Medicine, South Valley University, 83523 Qena, Egypt.,National Blood Bank Services, Qena, Egypt.,Department of Botany, Faculty of Science, South Valley University, 83523 Qena, Egypt
| | | | - Hamdi Ramdan Galal
- Department of Botany, Faculty of Science, South Valley University, 83523 Qena, Egypt
| | - Shamardan Ezzeldin S Bazeed
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, South Valley University, 83523 Qena, Egypt
| | - Serageldeen Sultan
- Department of Microbiology, Virology Division, Faculty of Veterinary Medicine, South Valley University, 83523 Qena, Egypt
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Kansay S, Sekhon J, Rana S. Seroprevalence of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among hemodialysis patients in a Tertiary Care Teaching Hospital in a developing country. Indian J Sex Transm Dis AIDS 2019; 40:120-125. [PMID: 31922101 PMCID: PMC6896388 DOI: 10.4103/ijstd.ijstd_53_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) prevalence in hemodialysis patients varies geographically, both within and between countries. High prevalence of these infections in dialysis patients reflects the increased presence of common risk factors for their acquisition, including transfusion, transplantation, history of drug abuse, plus susceptibility to nosocomial transmission during dialysis. OBJECTIVE The aim of this study is to investigate the seroprevalence and clinical profile of HIV, HBV, and HCV patient's on hemodialysis. MATERIALS AND METHODS Clinical and epidemiological data of patients undergoing maintenance hemodialysis in the dialysis unit of a teaching institution were obtained and analyzed over a 5 years' period. RESULTS A total of 127 males and 69 females were studied. Their mean age was 50.45 years. Out of the total 196 dialysis-dependent patients, 2 (1.02%) were seropositive for HIV antibodies, 6 (3.06%) were hepatitis B surface antigen positive, and 30 (15.30%) were anti-HCV antibody positive. There was no coexistence of HIV, HBV, and HCV markers. The major primary renal diseases in hemodialysis patients included diabetes mellitus (42%), hypertension (22%), chronic nephritis (15%), urologic diseases (6%), cystic renal diseases (4%), and others (11%). CONCLUSION Prevalence of transfusion-transmissible viral infections was higher among hemodialysis patients, especially HCV infection which was an alarming situation and therefore strict adherence to infection control strategies, barrier precautions, and preventive measures, including routine hepatitis B vaccination and regular virological follow-up were recommended along with regular education and training programs of technical and nursing personnel's involved with dialysis patients.
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Affiliation(s)
- Sonam Kansay
- Department of Transfusion Medicine, Gian Sagar Medical College and Hospital, Patiala, Punjab, India
| | - Jannat Sekhon
- Department of General Medicine, Gian Sagar Medical College and Hospital, Patiala, Punjab, India
| | - Saifi Rana
- Department of General Medicine, Gian Sagar Medical College and Hospital, Patiala, Punjab, India
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Abdel-Maksoud NHM, El-Shamy A, Fawzy M, Gomaa HHA, Eltarabilli MMA. Hepatitis B variants among Egyptian patients undergoing hemodialysis. Microbiol Immunol 2019; 63:77-84. [PMID: 30680771 DOI: 10.1111/1348-0421.12670] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/26/2018] [Accepted: 01/16/2019] [Indexed: 12/17/2022]
Abstract
Hepatitis B virus (HBV) infection is a serious nosocomial infection that affects patients undergoing hemodialysis (HD). However, certain HBV variants are not detected by routine serological tests in Egyptian dialysis units because of mutations that change important viral antigens (Ags). Of note, these mutations can result in the appearance of different HBV variants with different clinical manifestations. Thus, the present study aimed to assess different clinical forms of HBV infections and viral genotypes among patients undergoing HD in the Ismailia governorate of Egypt. To this end, serum samples were collected from 150 patients undergoing HD and screened for HBV-DNA using a nested PCR technique. Positive samples were then screened for HBV serological markers (hepatitis B core antibody [HBcAb], hepatitis B surface antigen, hepatitis B surface antibody, hepatitis B e antigen and hepatitis B e antibody) using ELISA and the HBV viral load quantitated by qPCR. HBV genotypes were detected by direct sequencing of the partial surface (S) gene. The most common clinical form of HBV infection in our study cohort was overt HBV infection (10%); followed by seropositive occult hepatitis B infection (7.3%), most of whom had an isolated HBcAb. The least common form was the precore mutant (1.3%). All HBV isolates were genotype D. This study reveals the importance of HBcAb and PCR in screening for HBV, especially for detection of occult hepatitis B infection.
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Affiliation(s)
| | - Ahmed El-Shamy
- Department of Pharmaceutical and Biomedical Sciences, Collage of Pharmacy, Department of Basic Sciences, College of Medicine, California Northstate University, Elk Grove, CA, USA
| | - Mohamed Fawzy
- Faculty of Veterinary Medicine, Department of Virology, Suez Canal University, Ismailia, Egypt
| | - Hanaa H A Gomaa
- Faculty of Science, Department of Botany, Suez Canal University, Ismailia, Egypt
| | - Mokhtar M A Eltarabilli
- Faculty of Veterinary Medicine, Department of Virology, Suez Canal University, Ismailia, Egypt
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Jakupi X, Mlakar J, Lunar MM, Seme K, Rudhani I, Raka L, Vince A, Poljak M. A very high prevalence of hepatitis C virus infection among patients undergoing hemodialysis in Kosovo: a nationwide study. BMC Nephrol 2018; 19:304. [PMID: 30390638 PMCID: PMC6215601 DOI: 10.1186/s12882-018-1100-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 10/12/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Patients on hemodialysis are at high risk for hepatitis C virus (HCV) infection if measures for effective control of HCV infection in the hemodialysis environment are not implemented. Whereas in developed countries isolated small-scale outbreaks of HCV in hemodialysis units are occasionally reported, HCV transmission in the hemodialysis environment still represents a substantial problem in low-resource countries. This study systematically assessed the prevalence of HCV infection among all patients at all hemodialysis centers in Kosovo, determined the HCV genotype distribution, and reviewed the main risk factors associated with HCV infection in this group of patients. METHODS From January to March 2013, blood samples from all patients undergoing hemodialysis at all seven hemodialysis centers in Kosovo were collected. The samples were screened for the presence of anti-HCV antibodies, and seropositive samples were also tested for HCV RNA. Genotyping was performed by sequencing the core region of the HCV genome. Subsequently, face-to-face interviews were conducted with consented patients attending hemodialysis in December 2015 and with the management of all hemodialysis centers in Kosovo. RESULTS The overall seroprevalence of HCV infection among hemodialysis patients in Kosovo was 53.0% (354/668), ranging from 22.3 to 91.1% at different centers. HCV RNA was detected in 323/354 (91.2%) seropositive patients. The most frequent HCV genotype was genotype 1a (62.2%), followed by genotypes 4d (33.1%), 1b (4.0%), and 2c (0.7%). The duration of hemodialysis and receiving dialysis at more than one center were identified as independent significant predictors of anti-HCV positivity. Shortage of staff, lack of resources, and inconsistent use of hygienic precautions and/or isolation strategies were observed. CONCLUSIONS The prevalence of HCV infection among hemodialysis patients in Kosovo is extremely high. The relatively low prevalence of HCV infection in the general population, predominance of two otherwise rare HCV genotypes among hemodialysis patients, and longer history of hemodialysis as a predictor of HCV infection all indicate nosocomial transmission due to inappropriate infection control practices as the main transmission route.
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Affiliation(s)
- Xhevat Jakupi
- Department of Microbiology, Kosovo National Institute of Public Health, Rrethi i Spitalit, p.n, 10000 Prishtina, Kosovo
| | - Jana Mlakar
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Maja M. Lunar
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Katja Seme
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Ibrahim Rudhani
- Clinic for Nephrology, University Medical Center of Kosovo, Bulevardi i Dëshmorëve, p.n, 10000 Prishtina, Kosovo
| | - Lul Raka
- Faculty of Medicine, Hasan Prishtina University of Prishtina, Bulevardi i Dëshmorëve, p.n, 10000 Prishtina, Kosovo
| | - Adriana Vince
- Dr Fran Mihaljević University Hospital for Infectious Diseases, Mirogojska 8, 10000 Zagreb, Croatia
| | - Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
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Hasanjani Roushan MR, Farokhtabar S, Bayani M, Siadati S. Epidemiological Aspects of Hepatitis B and C and Human Immunodeficiency Viruses Among Hemodialysis Patients in Mazandaran Province, Iran. Nephrourol Mon 2016; 8:e37878. [PMID: 27570757 PMCID: PMC4983454 DOI: 10.5812/numonthly.37878] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 04/08/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hemodialysis patients are potentially susceptible to infection with blood-borne viral agents, especially hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). OBJECTIVES The aim of this study was to evaluate the prevalence and incidence of HBV, HCV, and HIV infections in hemodialysis patients. PATIENTS AND METHODS This study was carried out in 482 hemodialysis patients who had been referred to eight dialysis centers in the Mazandaran province in Iran from 2012 - 2014. HBs Ag, HCV Ab, HBs Ab and HIV Ab were assessed every three months for two years. The patients' demographic characteristics, including age, gender, area of residence, and duration of dialysis, were noted. The prevalence of each virus was also determined. RESULTS From a total of 482 patients, 253 (52.5%) males and 229 (47.5%) females were evaluated. The mean age of all patients was 54.96 ± 16.1 years, and all participants were HIV negative. One subject had both HBV and HCV infections. HBs Ag and anti-HCV were detected in 10 (2.1%) and 40 (8.27%) patients, respectively. The mean age of HCV-positive patients was 55.4 ± 16.4, while HCV-negative patients were an average of 51.6 ± 10.7 years old (P = 0.002). The incidence of HCV was higher in people from 40-59 years of age (P < 0.001). No patients had HBV, and incidence of HCV was 0.5% in the first year and 0.75 in the second year. No cases of HIV were identified. CONCLUSIONS The results show that the prevalence rates of HBV and HCV in hemodialysis patients were moderate to low in the Mazandaran province. Based upon the obtained levels of these viruses, these incidence rates are therefore reasonable.
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Affiliation(s)
| | | | - Masomeh Bayani
- Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, IR Iran
- Corresponding author: Masomeh Bayani, Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, IR Iran, E-mail:
| | - Sepideh Siadati
- Department of Pathology, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, IR Iran
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Abou Rached A, El Khoury L, El Imad T, Geara AS, Jreijiry J, Ammar W. Incidence and prevalence of hepatitis B and hepatitis C viruses in hemodialysis patients in Lebanon. World J Nephrol 2016; 5:101-107. [PMID: 26788469 PMCID: PMC4707162 DOI: 10.5527/wjn.v5.i1.101] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Revised: 08/09/2015] [Accepted: 10/27/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine the incidence and the prevalence of hepatitis B and C viral infections in patients on hemodialysis (HD) across Lebanon.
METHODS: We reviewed the data registry at the Lebanese Ministry of Public Health where records of monthly hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) serology are reported from 60 affiliated HD centers across Lebanon. All patients who were on HD or who started HD between October 2010 and July 2012 were included in the study. Patients from seven HD centers were excluded due to inadequate and incomplete results reporting. During the selected period, HBsAg and HCV serology were available for 3769 patients from 53 HD centers distributed at all Lebanese governorates. The prevalence was calculated by dividing the number of patients with positive HBsAg or HCV serology to the total number of patients. The Incidence was calculated by dividing the number of newly acquired infection to number of patients-years (p-y). Incidence rates at different governorates were compared to each other using two tailed Z test and a P value of < 0.05 was considered significant.
RESULTS: Sixty out of 3769 HD patients were found to have positive HBS Ag and 177 out of 3769 were positive for HCV Antibodies. The prevalence of hepatitis B virus (HBV) and HCV in HD patients across Lebanon was 1.6%, and 4.7%, respectively. The comparison of prevalence according to geographic distribution could not be done accurately due to the frequent shift of patients between dialysis centers at different governorates. The incidence rate was 0.27 per 100 p-y for HBV and 0.37 per 100 p-y for HCV. There was no significant difference concerning the incidence of HBV between HD centers at different governorates (all P values > 0.1), but this difference was highly significant concerning the incidence rates of HCV which occurred predominantly in the southern centers (1.47 per 100 p-y) with a P value of 0.00068 and 0.00374 when compared to Mount Lebanon (0.21 per 100 p-y) and the Northern centers (0.19 per 100 p-y), respectively.
CONCLUSION: The incidence rate of HBV and HCV is very low in the Lebanese HD centers and their prevalence is decreasing over the last two decades.
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Schiller A, Timar R, Siriopol D, Timar B, Bob F, Schiller O, Drug V, Mihaescu A, Covic A. Hepatitis B and C Virus Infection in the Hemodialysis Population from Three Romanian Regions. Nephron Clin Pract 2015; 129:202-8. [DOI: 10.1159/000371450] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 12/09/2014] [Indexed: 11/19/2022] Open
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Murad EA, Babiker SM, Gasim GI, Rayis DA, Adam I. Epidemiology of hepatitis B and hepatitis C virus infections in pregnant women in Sana'a, Yemen. BMC Pregnancy Childbirth 2013; 13:127. [PMID: 23758990 PMCID: PMC3684507 DOI: 10.1186/1471-2393-13-127] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 06/05/2013] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Screening for Hepatitis B and C during pregnancy may help to decide on appropriate antiviral therapy and the institution of steps to minimize vertical transmission to the newborn infants. METHODS A cross-sectional study was conducted during November-December 2011 to investigate the seroprevalence and associated risk factors for markers of HBV (hepatitis B surface antigen; HBsAg) and anti-HCV antibody among pregnant women at the Al-Thawra hospital in Sana'a, Yemen. Structured questionnaires were used to obtain sociodemographic obstetrics and medical data and sera were tested for HBsAg and anti-HCV. RESULTS Of the 400 pregnant women enrolled in the study, HBsAg and anti-HCV were detected in 43 (10.8%; 95% CI: 8.0-14.0%) and 34 (8.5%, 95% CI: 6.0-11.5%) women, respectively. None of the women were co-infected with HBV and HCV. Multivariate analysis showed that circumcision was significantly associated with HBsAg seropositivity (OR = 3.3, 95% CI: 1.1-10.2; p = 0.03), low parity (primigravidae and secundigravidae) and education below secondary level were significantly associated with anti- HCV seropositivity (OR = 3.3, 95% CI: 1.1-10.2; p = 0.03). No other sociodemographic or clinical characteristics (age, residence, history of home delivery, miscarriage, dental manipulation, surgery, and blood transfusion) were significantly associated with HBsAg or anti-HCV seropositivity. CONCLUSION The results of this study suggest that HBsAg and anti-HCV have high prevalence among pregnant women.
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Affiliation(s)
- Entisar A Murad
- Department of Obstetrics and Gynecology, AL Kuwait hospital, Sana’a, Yemen
| | - Suad M Babiker
- Faculty of Medicine, Alzaiem Alazhari University, Khartoum North, Sudan
| | - Gasim I Gasim
- Faculty of Medicine, University of Khartoum, P O Box102, Khartoum, Sudan
| | - Duria A Rayis
- Faculty of Medicine, University of Khartoum, P O Box102, Khartoum, Sudan
| | - Ishag Adam
- Faculty of Medicine, University of Khartoum, P O Box102, Khartoum, Sudan
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Onuigbo MAC, Onuigbo NTC. De novo HBV infection in a Mayo Clinic hemodialysis population: economic impact of reduced HBV testing and a call for changes in current US CDC guidelines on HBV testing protocols. Hemodial Int 2013; 16 Suppl 1:S32-8. [PMID: 23036034 DOI: 10.1111/j.1542-4758.2012.00748.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Hemodialysis (HD) exposes end-stage renal disease patients to significantly higher risks for Hepatitis B Virus (HBV) infection, a major public health scourge. Therefore, current US CDC guidelines, last revised in 2001, call for monthly HbsAg tests. The charge to Medicare per HbsAg test is $100. In an economic analysis, we hypothesized that in the new environment of Medicare Fee Bundling, this is unwise and wasteful if de novo HBV infection rate among HD patients is <1%. We determined de novo HBV infection rate among a Mayo Clinic HD cohort, July 2000-July 2010. A retrospective analysis of all relevant medical records of the cohort was completed to identify de novo HBV infection. Nine hundred sixty-five HD patients were analyzed. One case of de novo HBV infection was identified in a 54-year old known IV drug user, a previous Hepatitis C carrier. This translates to a de novo HBV case incidence rate of 0.1%. De novo HBV infection among HD patients in the US, 2000-2010, is only 0.1%. In the early 1970s, rates were as high as 30%. We recommend 3-monthly HbsAg testing, but to continue current monthly testing for IV drug users and other high-risk groups. Huge cost savings would result, without any compromise of quality outcomes. With over 500,000 HD patients, this represents a mind-boggling $40 billion savings in Medicare charges over 10 years. The US CDC should revise these outdated guidelines, last revised in 2001, to fall in line with current clinical realities on the ground.
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Alashek WA, McIntyre CW, Taal MW. Hepatitis B and C infection in haemodialysis patients in Libya: prevalence, incidence and risk factors. BMC Infect Dis 2012; 12:265. [PMID: 23082935 PMCID: PMC3507892 DOI: 10.1186/1471-2334-12-265] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 10/16/2012] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Patients receiving maintenance haemodialysis (HD) are at higher risk for acquiring Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infections than the general population. Strict infection control measures are essential to prevent nosocomial transmission. We aimed to investigate the incidence and prevalence of HBV and HCV infection in the HD population of Libya as well as risk factors for infection. METHODS All adult patients receiving maintenance HD (n=2382) in Libyan dialysis centres (n=39) were studied between May 2009 and October 2010. Testing for Hepatitis B surface antigen (HBsAg) and anti-HCV antibodies was performed at initiation of dialysis and every 3-6 months thereafter. Patients who were sero-negative for HBV and HCV (n=1160) were followed up for 1 year to detect sero-conversions. RESULTS Participant median age was 49 years and 58% were male. 831 patients (34.9%) were sero-positive for HBV and/or HCV (anti-HCV positive 31.1%; HBsAg positive 2.6%; both positive 1.2%). Of the sero-positive patients 4.7% were known to be infected before the initiation of HD. The prevalence of HBV±HCV infection varied widely between HD centres from 0% to 75.9%. Sero-positive patients were younger, had longer time on dialysis and more previous blood transfusions. Prospective follow-up revealed an incidence of sero-conversion of 7.7% during 1 year (7.1% HCV; 0.6% HBV). Wide variation in rates of newly acquired infections was observed between dialysis centres. All new HBV cases were referred from centres already treating HBV infected patients. New HCV infections were reported in most centres but the rate of HCV sero-conversion varied widely from 1.5% to 31%. Duration of dialysis, history of previous renal transplant and history of receiving HD in another centre in Libya were significantly associated with sero-conversion. CONCLUSION Patients on maintenance HD in Libya have a high incidence and prevalence of HCV infection and lower rates of HBV infection. The factors associated with HBV and HCV infection are highly suggestive of nosocomial transmission within HD units. Urgent action is required to improve infection control measures in HD centres and to reduce dependence on blood transfusions for the treatment of anaemia.
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Affiliation(s)
- Wiam A Alashek
- School of Graduate Entry Medicine, University of Nottingham, Nottingham, UK.
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14
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Aghakhani A, Banifazl M, Eslamifar A, Ahmadi F, Ramezani A. Viral Hepatitis and HIV Infection in Hemodialysis Patients. HEPATITIS MONTHLY 2012; 12:463-4. [PMID: 23008728 PMCID: PMC3437459 DOI: 10.5812/hepatmon.6959] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 06/18/2012] [Accepted: 06/28/2012] [Indexed: 12/11/2022]
Affiliation(s)
- Arezoo Aghakhani
- Clinical Research Department, Pasteur Institute of Iran, Tehran, IR Iran
| | - Mohammad Banifazl
- Iranian Society for Support of Patients With Infectious Diseases, Tehran, IR Iran
| | - Ali Eslamifar
- Clinical Research Department, Pasteur Institute of Iran, Tehran, IR Iran
| | - Farrokhlagha Ahmadi
- Nephrology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Amitis Ramezani
- Clinical Research Department, Pasteur Institute of Iran, Tehran, IR Iran
- Pediatric Infectious Disease Research Center, Tehran University of Medical sciences, Tehran, IR Iran
- Corresponding author: Amitis Ramezani, Clinical Research Department, Pasteur Institute of Iran, No 69, Pasteur Ave., Tehran, 13164, IR Iran. Tel.: +98-2166968852, Fax: +98-2166465147, E-mail:
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15
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Gasim GI, Hamdan HZ, Hamdan SZ, Adam I. Epidemiology of hepatitis B and hepatitis C virus infections among hemodialysis patients in Khartoum, Sudan. J Med Virol 2011; 84:52-5. [PMID: 22052648 DOI: 10.1002/jmv.22256] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2011] [Indexed: 12/12/2022]
Abstract
The epidemiology of hepatitis B virus (HBV) and hepatitis C virus (HCV) is important for health planners and service providers. A cross-sectional study was conducted to investigate the seroprevalence and associated risk factors for markers of HBV (HBsAg) and anti-HCV among hemodialysis patients at the Ahmed Gasim hemodialysis unit, Sudan. Structured questionnaires were used to obtain socio-demographic data and sera were tested for hepatitis B surface antigen (HBsAg) and antibody to HCV (anti-HCV). Of the 353 patients enrolled in the study, HBsAg and anti-HCV were detected in 16 (4.5%) and 30 (8.5%) patients, respectively. None of the patients were co-infected with HBV and HCV. Multivariate analysis showed that duration of dialysis was significantly associated with anti-HCV seropositivity [OR = 1.1, 95% CI = 1.2-1.3; P = 0.024]. No other socio-demographic or clinical characteristics (age, sex, level of education, history of surgery, and number of units of blood transfused) were significantly associated with HBsAg or anti-HCV seropositivity. The results of this study suggest that HBsAg and anti-HCV have low prevalence among hemodialysis patients in Khartoum. Longer duration of dialysis was a risk factor for anti-HCV.
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Affiliation(s)
- Gasim I Gasim
- Faculty of Medicine, Qassim University, Qassim, Kingdom of Saudi Arabia
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16
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Joukar F, Besharati S, Mirpour H, Mansour-Ghanaei F. Hepatitis C and hepatitis B seroprevalence and associated risk factors in hemodialysis patients in Guilan province, north of Iran: HCV and HBV seroprevalence in hemodialysis patients. HEPATITIS MONTHLY 2011; 11:178-81. [PMID: 22087139 PMCID: PMC3206684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Revised: 10/10/2010] [Accepted: 11/22/2010] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) and hepatitis B virus (HBV) infection are especially problematic in patients with end-stage renal disease who are undergoing hemodialysis (HD). OBJECTIVES To determine the prevalence of HCV and HBV infection in HD population in Guilan, north of Iran. PATIENTS AND METHODS In a cross-sectional study, from May to September 2009, in 11 different hemodialysis units in Guilan province, North of Iran, clinical data such as age, gender, duration of dialysis, HBsAg and anti-HCV antibody of 514 HD patients were recorded. Patients with positive antibodies against HCV were tested for HCV RNA. RESULTS From 514 patients, 286 (55.64%) were male. 61 (11.9%) patients were anti-HCV-positive and 31 (50.8%) were HCV PCR-positive. There was significant relationship between HCV Ab-positivity with gender and HD duration (p < 0.05). There was significant difference between the mean HD duration in anti-HCV-positive and anti-HCV-negative patients (p < 0.05). Also, significant relationship was found between HCV RNA-positivity with gender and HD duration (p < 0.05). Seven (1.4%) patients were positive for HBsAg. Two (0.38 %) were found positive for both HBsAg and anti-HCV antibody. CONCLUSIONS There is low a prevalence of HCV and HBV in HD patients in our region. The rate can be decreased by HBV vaccination of end-stage renal disease patients before setting chronic HD, antiviral treatment and isolation of infected individuals.
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Affiliation(s)
- Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, IR Iran
| | - Sepiedeh Besharati
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, IR Iran
| | - Hasan Mirpour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, IR Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, IR Iran,* Corresponding author at: Fariborz Mansour-Ghanaei, Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Razi Hospital, Sardar-Jangle Ave, PO Box: 41448-95655, Rasht, IR Iran. Tel.: +98-1315535116, Fax: +98-1315534951, E-mail:
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