Viral Hepatitis and HIV Infection in Hemodialysis Patients

Seroprevalence occurrence of viral hepatitis and HIV among hemodialysis patients

Background

Patients with chronic renal failure (CRF) were on maintenance invasive hemodialysis (HD) procedure. This procedure by itself affects immunity of the patients and became more susceptible to viral infections.

Aim of the study

to investigate the occurrence of HBV, HCV and HIV infections in patients with hemodialysis.

Patients and methods

A retrospective study of 430 end-stage renal failure patients, referred to hemodialysis department at XXXX Teaching Hospital, Baghdad-Iraq from January-2015 to January-2017. Patients were investigated for HBs-Ag using enzyme-labeled antigen test (Foresight-EIA-USA), HCV- Abs (IgG) specific immunoglobulin using an HCV enzyme-labeled antigen test (Foresight-EIA-USA)and anti - HIV Abs (IgG) using enzyme-labeled antigen test (Foresight-EIA-USA).

Results

The frequency of HBV infection in the first year was not significant between males (1.11%) and females (0.00%) (P = 0.295). About HCV also there are no significant differences between males (12.63%) and females (9.31%) (P = 0.347). After one year of follow up the frequencies of HBV and HCV were not significant between two sexes. Additionally, no any one of the patients had HIV infection.

Conclusions

This study brings a light on that HBV and HCV were having the same frequencies in both genders and lower occurrence with time. Furthermore, HIV was not detected in those patients.

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Patients were on hemodialysis.

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This procedure by itself affects immunity.

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HBV and HCV were having the same frequencies in both genders and lower occurrence with time.

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HIV was not detected in those patients.

Hepatitis B virus and hepatitis C virus co-infection in hemodialysis patients: A retrospective study from a tertiary care hospital of North India

Background:

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections represent significant public health issues globally. They are important causes of morbidity and mortality in hemodialysis patients. Patients with HBV/HCV co-infection have a higher risk of progression to cirrhosis and decompensated liver disease and have an increased risk of hepatocellular cancer (HCC). Because the two hepatotropic viruses share same modes of transmission, co-infection with the two viruses is not uncommon, especially in areas with a high prevalence of HCV infection and among people at high-risk for parenteral infection.

Aims:

To estimate the prevalence of HBV and HCV co-infection among hemodialysis patients.

Materials and Methods:

This retrospective, single centered hospital record-based study was carried out in a tertiary care hospital in Faridkot (Punjab), India. All the patients who underwent hemodialysis from January 2013 to December 2014 were included in the study. Patients of all age groups were tested for anti-HCV antibodies by fourth Generation HCV Tridot ELISA (J. Mitra & Co. Pvt. Ltd., New Delhi, India) and for hepatitis B surface antigen (HBsAg) by Hepalisa (J. Mitra & Co. Pvt. Ltd).

Results:

Of the total 262 patients on hemodialysis, 88 (33.5%) were found to be having HCV infection, 4 (1.5%) were found to be positive for HBsAg. Co-infection with HBV/HCV was observed in 2 (0.8%) patients. Out of the total 92 patients having HBV and HCV infection, 62 (67.4%) were males and 30 (32.6%) were females. The majority of the patients were found to be of 41-60 years of age (41.3%) followed by 21-40 years (31.5%) and thereafter in 61-80 years (23.9%) and lowest prevalence was observed in the age group of <20 years (2.2%) and >80 years (1.1%).

Conclusion:

The risk of co-infection is greater among the chronic renal failure (CRF) patients due to the high frequency of transfusions of blood/blood products and extracorporeal circulation during hemodialysis. Patients with HBV/HCV co-infection have a higher risk of progression to cirrhosis and decompensated liver disease and further have an increased risk of HCC. In our study, out of the total 262 patients, 88 (33.5%) were found to be having HCV infection, 4 (1.5%) were found to be positive for HBsAg and dual infection was observed in 2 (0.8%) patients which is higher than the rates reported from different studies all over the world and India.

Health related quality of life in Iranian hemodialysis patients with viral hepatitis: changing epidemiology

BACKGROUND

There are surprisingly a few studies that evaluate the impact of chronic viral hepatitis, which is common in HD (hemodialysis) patients, on HRQOL (health related quality of life).

OBJECTIVES

We conducted a study to evaluate the impact of chronic viral hepatitis on HRQOL and to compare their HRQOL with non-infected HD patients via a HRQOL questionnaire.

PATIENTS AND METHODS

The Iranian adapted version of the Kidney Disease Quality of Life Short Form (KDQOL-SF) version 1.3 questionnaires were filled out by the HD patients. In all HD patients, serum HBsAg, HBS Abs, and HCV Abs [enzyme-linked immunosorbant assay (ELISA)] were routinely checked every six months. Patients were considered to have chronic HBV infection if HBsAg was positive for more than six months. In all HD patients, third generation assay was used to detect HCV infection. Furthermore, serum HCV-RNA (PCR) was examined in anti-HCV-positive patients for confirmation of HCV infection.

RESULTS

in this cross sectional study 4101 patients from 103 dialysis units in Iran between October 2010 and August 2011 were included. Prevalence of hepatitis B and hepatitis C infection was 2.1% and 1.3% respectively. Almost all KDQOL items for viral hepatitis patients had equivalent or better scores than those without viral hepatitis. In the logistic regression after adjustment for age, sex, educational level, marital status, dialysis vintage, HBs Ag positivity and HCV Ab positivity, only age (P < 0.001) and educational level (P = 0.015) had negative impact on quality of life.

CONCLUSIONS

Our data show that not only general health and physical activity were preserved but also health perception may be better among HD patients with viral hepatitis.

Hepatitis viruses in heamodialysis patients: an added insult to injury?

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.