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Kenfack-Momo R, Ngounoue MD, Kenmoe S, Takuissu GR, Ebogo-Belobo JT, Kengne-Ndé C, Mbaga DS, Zeuko’o Menkem E, Lontuo Fogang R, Tchatchouang S, Ndzie Ondigui JL, Kame-Ngasse GI, Kenfack-Zanguim J, Magoudjou-Pekam JN, Bowo-Ngandji A, Mahamat M, Nkie Esemu S, Ndip L, Njouom R. Global epidemiology of hepatitis C virus in dialysis patients: A systematic review and meta-analysis. PLoS One 2024; 19:e0284169. [PMID: 38330063 PMCID: PMC10852299 DOI: 10.1371/journal.pone.0284169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/25/2023] [Indexed: 02/10/2024] Open
Abstract
Dialysis is a replacement therapy for patients with End-Stage Renal Disease (ESRD). Patients on dialysis are at high risk of acquiring hepatitis C virus (HCV), which has become a leading cause of morbidity and mortality in this population. There is a wide range of prevalence of HCV in dialysis populations around the world. It is still unknown how prevalent HCV infection is among worldwide dialysis patients (including those undergoing hemodialysis and peritoneal dialysis). A review was conducted to estimate the global epidemiology of hepatitis C in dialysis patients. We searched PubMed, Excerpta Medica Database (Embase), Global Index Medicus and Web of Science until October 2022. A manual search of references from relevant articles was also conducted. Heterogeneity was evaluated by the χ2 test on Cochrane's Q statistic, and the sources of heterogeneity were investigated using subgroup analysis. In order to assess publication bias, funnel plots and Egger tests were conducted, and pooled HCV prevalence estimates were generated using a DerSimonian and Laird meta-analysis model. The study is registered with PROSPERO under CRD42022237789. We included 634 papers involving 392160 participants. The overall HCV case fatality rate was 38.7% (95% CI = 28.9-49). The global prevalence of HCV infection in dialysis population group were 24.3% [95% CI = 22.6-25.9]. As indicated by UNSD region, country, dialysis type, and HCV diagnostic targeted; Eastern Europe had the highest prevalence of 48.6% [95% CI = 35.2-62], Indonesia had 63.6% [95% CI = 42.9-82], hemodialysis patients had 25.5% [95% CI = 23.8-27.3], and anti-HCV were detected in 24.5% [95% CI = 22.8-26.2]. Dialysis patients, particularly those on hemodialysis, have a high prevalence and case fatality rate of HCV infection. Hemodialysis units need to implement strict infection control measures.
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Affiliation(s)
- Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde, Cameroon
| | | | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Guy Roussel Takuissu
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala, Cameroon
| | | | | | | | | | | | - Ginette Irma Kame-Ngasse
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | | | | | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | - Maimouna Mahamat
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
- Hemodialysis Unit, Yaoundé General Hospital, Yaoundé, Cameroon
| | | | - Lucy Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Richard Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaoundé, Cameroon
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Shamsdin SA, Fatahi MR, Ansari AR, Safarpour AR. Prevalence of HBV, HCV, and HIV Infections among Patients Undergoing Hemodialysis in Fasa, Iran: A Six-Year Follow-up Study. Middle East J Dig Dis 2022; 14:317-322. [PMID: 36619273 PMCID: PMC9489426 DOI: 10.34172/mejdd.2022.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/07/2022] [Indexed: 11/06/2022] Open
Abstract
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.
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Affiliation(s)
- Seyedeh Azra Shamsdin
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohamad Reza Fatahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Reza Ansari
- Department of Internal Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Ali Reza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Corresponding Author: Ali Reza Safarpour, MD Assistant Professor, Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Tel:+98 716281442 Fax:+98 716281442
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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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Seroprevalence of Hepatitis A and Hepatitis E Viruses among Pregnant Women in Northern Iran. Infect Dis Obstet Gynecol 2021; 2021:5130586. [PMID: 34305391 PMCID: PMC8272671 DOI: 10.1155/2021/5130586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/28/2021] [Indexed: 01/14/2023] Open
Abstract
Background Hepatitis A (HAV) and hepatitis E viruses (HEV) are endemic in Iran and are known major causes of acute viral hepatitis. Also, during pregnancy, they are associated with severe outcomes. Therefore, it is vital to evaluate the antibody levels against HAV and HEV in pregnant women to avoid severe outcomes incidence. Study design and methods. A total of 247 pregnant women were enrolled in this prospective cross-sectional study. In addition to completing the questionnaire and interviewing all participants, the serum samples were tested for anti-HAV and anti-HEV IgG using the enzyme-linked immunosorbent assay (ELISA). The association between anti-HAV and anti-HEV antibodies status and risk factors was evaluated. Results The mean age of patients was 28.06 ± 5.29 years. Anti-HAV antibody was found in 111 patients (44.9%), while anti-HEV antibody was detected in only two pregnant women (0.8%). The seroprevalence of HAV was inversely related to the level of education. There was no significant correlation between HAV antibody levels and age, marital status, residence location, and pregnancy trimesters. Conclusion Considering many complications of these diseases in pregnancy, the detection of enteroviral hepatitis, especially HAV in pregnant women, is necessary, and therefore, proactive measures, such as promoting education, improving people awareness, and vaccination, are recommended.
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Adane T, Getawa S. The prevalence and associated factors of hepatitis B and C virus in hemodialysis patients in Africa: A systematic review and meta-analysis. PLoS One 2021; 16:e0251570. [PMID: 34157037 PMCID: PMC8219139 DOI: 10.1371/journal.pone.0251570] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/28/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Due to its invasive procedure patients on hemodialysis (HD) are at high risk of infections. Infections acquired in dialysis units can prolong hospitalization date and/or prolong illness in patients, and increase treatment cost. There are no adequate data on the prevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections in HD patients. Therefore, this study aimed to estimate the pooled prevalence and associated factors of HBV and HCV infections among HD patients in Africa. METHOD The databases PubMed, Medline, EMBASE, Cochrane library, web of science, African Journals Online, Science Direct, and Google Scholar were searched to identify relevant studies. The review was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were extracted independently by two authors and analyzed using STATA 11. A random-effect model was fitted to estimate the pooled prevalence with their 95% confidence interval. To detect publication bias funnel plots analysis and Egger weighted regression tests were done. RESULTS The overall pooled prevalence of HBV and HCV infection among HD patients in Africa was 9.88% (95% CI: 7.20-12.56) I2 = 97.9% and 23.04% (95% CI: 18.51-2757) I2 = 99.6%, respectively. In addition, the pooled prevalence of HBV and HCV co-infection was 7.18% (95% CI: 3.15-11.20) I2 = 99.6%. Duration of dialysis was found to be the contributing factor for the occurrence of HBV and HCV among HD patients (OR = 1.44; 95% CI: 1.04, 2.01). CONCLUSION This study showed that there is high prevalence of HBV and HCV infections in HD patients in Africa. Therefore, strict adherence to precautions of infection control measures, isolation of seropositive patients, improvement in infrastructures, adequate screening of HBV and HCV for the donated blood, and decentralized HD services is needed to minimize the risk of HBV and HCV infections in HD facilities.
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Affiliation(s)
- Tiruneh Adane
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Solomon Getawa
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Hatatian F, Babakhani F, Gudarzi H, Momenifar N, Norouzi M, Shafieifar M, Kakavandi E, Sadeghi A, Sharbatdar-Alaei H, Farahmand M, Amiri-Roudy M, Jahantigh HR, Madihi M, Borhani K, Ajorloo M, Hedayat Yaghoobi M. Relative Frequency of Blood-Borne Viruses in Hemodialysis-Dependent and Kidney Transplant Recipients in Iran. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 49:2136-2143. [PMID: 33708734 PMCID: PMC7917503 DOI: 10.18502/ijph.v49i11.4731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Hemodialysis (HD) patients and kidney transplant (KT) recipients are exposed to be infected by blood-borne viruses (BBVs). Current study was conducted to evaluate the prevalence of BBVs in HD and KT patients in the whole Iranian population. Methods: From Jan 2016 to Dec 2017, 174 hemodialysis and 139 kidney transplant recipients enrolled in this survey. After blood sampling, serum samples were detected for HBV, HCV, HCMV, HIV and HTLV antibodies. Seropositive samples confirmed by Polymerase chain reaction (PCR) method. Results: Overall, 6 (3.44%) and 3 (2.15%) of hemodialysis-dependent and transplantation patients had evidence of HCV infection, whereas no patients were HIV and HBV positive, two cases (1.14%) of hemodialysis and one case (0.71%) of transplantation patients demonstrated the HTLV-1 infection. 52 (37.4%) of patients received graft were positive for HCMV antibody. In addition, our study showed a co-infection of HCMV with HCV (3 patients, 2.15%) in transplantation patients. Conclusion: Prevalence of BBVs infection was lower in comparison to the previous studies. The current strict infection control practices in Iran appear to be effective in limiting dialysis and related infections after transplantation. Because BBVs infections constantly occur especially in dialysis and after transplantation units, our data will be useful to build a new strategic plan for the elimination of BBVs infection in kidney therapycenters.
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Affiliation(s)
- Fatemeh Hatatian
- Inflammation and Inflammatory Disease Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzad Babakhani
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hoda Gudarzi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Navid Momenifar
- Human and Animal Cell Bank, Iranian Biological Resource Center, Academic Center of Education, Culture and Research, Tehran, Iran
| | - Mehdi Norouzi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Shafieifar
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Kakavandi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Sadeghi
- Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hedyeh Sharbatdar-Alaei
- Department of Microbial Biotechnology, Faculty of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran
| | - Mohammad Farahmand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maedeh Amiri-Roudy
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Jahantigh
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mobina Madihi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kiandokht Borhani
- Department of Virology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mehdi Ajorloo
- Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.,Department of Clinical Laboratory Sciences, School of Allied Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mojtaba Hedayat Yaghoobi
- Department of Infectious Disease, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
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Elahi W, Syed AZ, Nasim F, Anwar A, Hashmi AA. Hepatitis B and C Infections in Patients With Prolonged Hemodialysis Secondary to Chronic Renal Failure. Cureus 2020; 12:e10905. [PMID: 33194472 PMCID: PMC7657307 DOI: 10.7759/cureus.10905] [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] [Indexed: 12/11/2022] Open
Abstract
Objective To determine the frequency of hepatitis B and C in patients with prolonged hemodialysis suffering from chronic renal failure. Methods A retrospective study was conducted from January to August 2017 at Tabba Kidney Institute, Karachi. A total of 255 patients on hemodialysis were included in the study by using convenient sampling technique. All the relevant data such as gender, age, duration of hemodialysis and presence of hepatitis B and C were recorded. Data were analyzed using Statistical Package for Social Sciences, version 21 (IBM Corp., Armonk, NY) while binary logistic regression was applied to develop a risk assessment model for the study outcomes. Results The study results showed that 134 (52.5%) patients were on hemodialysis for five years or more, 173 (67.8%) of them suffered from hepatitis B while 124 (48.6%) of them suffered from hepatitis C. The study results further revealed that after controlling for the effects of age and gender, the duration of hemodialysis was significantly associated with both hepatitis B (AOR 1.917, 95% CI 1.111-3.306, p=0.019) and hepatitis C (AOR 2.323, 95% CI 1.395-3.870, p=0.001) among the patients studied. Conclusion The study concluded that longer duration of hemodialysis in patients with chronic renal failure was significantly associated with both hepatitis B and hepatitis C infections in the study population. A myriad of patient and environmental factors can contribute to this finding in patients with chronic renal insufficiency. Therefore, periodic monitoring of liver function tests and routine surveillance for viral hepatitis can help establish an early diagnosis of infection, potentially improving patient outcomes improving patient outcome.
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Affiliation(s)
| | | | - Fahad Nasim
- Nephrology, Liaquat National Hospital and Medical College, Karachi, PAK
| | - Adnan Anwar
- Physiology, Al-Tibri Medical College, Karachi, PAK.,Stereotactic Radiosurgery/Radiation Oncology, Al-Tibri Medical College, Karachi, PAK
| | - Atif A Hashmi
- Pathology, Liaquat National Hospital and Medical College, Karachi, PAK
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Ramezan Ghorbani N, Qorbani M, Djalalinia S, Kazemzadeh Atoofi M, Tajbakhsh R, Mansourian M, Gorabi AM, Asayesh H, Soleimani A, Noroozi M. Oncogenic Viral Infections Among Iranian Hemodialysis Patients: A Systematic Review. Int J Prev Med 2019; 10:216. [PMID: 31929863 PMCID: PMC6941381 DOI: 10.4103/ijpvm.ijpvm_458_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 11/25/2017] [Indexed: 02/04/2023] Open
Abstract
Introduction: Chronic hemodialysis is a lifesaving procedure for end-stage renal failure patients who may lead to the transmission of oncogenic viral infections discussed as a major cause of liver disease and a potential cause of substantial morbidity and mortality. In this regard, the hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most common infections that studied recently. This study aimed to review systematically all available documents on the prevalence of hepatitis D virus (HED), hepatitis E virus (HEV), hepatitis G virus (HGV), human T-lymphotropic virus (HTLV), human immunodeficiency virus (HIV), and Kaposi's sarcoma-associated herpes virus (KSHV) in Iranian hemodialysis patients. Methods: We conducted a comprehensive systematic review of literature on the prevalence and factors associated with HED, HEV, HGV, HTLV, HIV, and KSHV in Iranian hemodialysis patients. Using Medical Subject Headings (MeSH) terms, Emtree, and related equal Persian key words, irrespective of age, date, and language, the main domestic databanks of Barekat, Scientific Information Database (SID), Iran-doc, and also international databases of PubMed and NLM Gateway (for MEDLINE), Institute of Scientific Information (ISI), and SCOPUS searched. Interest outcome of infection prevalence was confirmed based on reported positive tests of blood samples. Since the studied factors are very numerous and there is even a high heterogeneity in each factor, so the meta-analysis was not performed. Results: Based on our search strategy through comprehensive searching, 509 studies were found. From them, 314 articles were from international data bases and others from Iranian data banks. After excluding duplicates and overlapping studies, 41 studies were included in the analysis; 11 studies were relevant to HIV, 10 studies assigned to HEV, and 7 studies belonged to HGV field. The HDV, HTLV1,2, and KSHV were the other research subject areas. The prevalence of HIV, HGV, and HTLV1,2 ranged from 0% to 1.5%, 0% to 24.19%, and 0.6% to 70.4%, respectively, in different provinces. Conclusions: This is the comprehensive systematic review on oncogenic viral infections prevalence in the Iranian hemodialysis patients. Present findings emphasize on requirement to evidence-based practical intervention for better prevention and control of problem. The findings could be used as a scientific evidence for developing related policies and highlighting the future plan of complementary researches.
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Affiliation(s)
- Nahid Ramezan Ghorbani
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Science, Karaj, Iran
| | - Shirin Djalalinia
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran, Iran
| | - Mehrdad Kazemzadeh Atoofi
- Spiritual Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Psychiatric Institute, Tehran, Iran
| | - Ramin Tajbakhsh
- Non-Communicable Diseases Research Center, Alborz University of Medical Science, Karaj, Iran
| | - Morteza Mansourian
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Armita Mahdavi Gorabi
- Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Ali Soleimani
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Mehdi Noroozi
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Ghorbani NR, Djalalinia S, Modirian M, Abdar ZE, Mansourian M, Gorabi AM, Asayesh H, Ansari H, Atoofi MK, Tajbakhsh R, Noroozi M, Safiri S, Qorbani M. Prevalence of hepatitis C infection in Iranian hemodialysis patients: An updated systematic review and meta-analysis. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2017; 22:123. [PMID: 29259634 PMCID: PMC5721496 DOI: 10.4103/jrms.jrms_223_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 06/02/2017] [Accepted: 09/03/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) is a major cause of liver disease and a potential cause of substantial morbidity and mortality. This study aims to provide a comprehensive evidence on HCV Infection in Iranian hemodialysis (HD) patients we conducted a systematic review. MATERIALS AND METHODS In this systematic review and meta-analysis, through a comprehensive search of literature until January of 2016, we estimated the pooled prevalence of hepatitis C infection in Iranian HD patients. Using Medical Subject Headings terms, Emtree, and related equal Persian key words for Iranian databases and also international databases of PubMed and NLM Gateway (for MEDLINE), and SCOPUS. Interest outcome of HCV infection prevalence was confirmed based on positive hepatitis B surface antigen of blood samples. Random effect meta-analysis was used to estimate pooled prevalence of HCV infection in Iranian HD patients, date and language, HD patients, in adult HD patients, Institute of Scientific Information, Iran-doc, irrespective of age, living in Iran. Searches run through main domestic databanks of Iran-Medex, renal transplantation, Scientific Information Database, the relevant literature-searched concentrating on HCV infection. RESULTS Through searching steps, 305 publications were found from them following the excluding duplicates and overlapping studies 54 studies relevant to HCV prevalence in Iranian HD zcxw patients, with number of 23921 participants, remained in our analyses. The overall results of test of heterogeneity demonstrate sever heterogeneity between reported prevalence (I2 = 96.62%, Chi-square = 1566, P < 0.001). Due to sever heterogeneity results of random effect meta-analysis showed that the estimated pooled prevalence was 11% (95% confidence interval [CI] =10%-13%). The pooled prevalence base on polymerase-chain reaction, recombinant immunoblot assay, and enzyme-Linked Immunosorbant Antibody method were 11% (95% CI = 6%-15%), 9% (95% CI = 5-13) and 12% (95% CI = 10-14), respectively. In line with previous studies, the present finding shows the significant variation in the rate of HCV in dialysis units among the regions in Iran. CONCLUSION Present paper is the comprehensive updated systematic review on HCV prevalence in the Iranian HD patients. Our findings provide the reliable evidence for promotion of policies and interventional programs.
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Affiliation(s)
- Nahid Ramezan Ghorbani
- Department of Development and Coordination Scientific Information and Publications, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Shirin Djalalinia
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Mitra Modirian
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Esmaeili Abdar
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Tehran, Iran
| | - Morteza Mansourian
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Health Education and Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Armita Mahdavi Gorabi
- Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Hossein Ansari
- Department of Epidemiology and Biostatistics, Health Promotion Research Center, Zahedan University of Medical Sciences, Tehran, Iran
| | - Mehrdad Kazemzadeh Atoofi
- Spiritual Health Research Center, School of Behavioral Sciences and Mental Health, Tehran Psychiatric Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Ramin Tajbakhsh
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Tehran, Iran
| | - Mehdi Noroozi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
INTRODUCTION Evidence has been accumulated during the last decade showing that HCV infection plays an important activity at hepatic and extra-hepatic level. Chronic HCV is associated with a large spectrum of extra-hepatic manifestations including lympho-proliferative diseases and metabolic abnormalities (such as insulin resistance and fatty liver disease). MATERIAL AND METHODS We have performed an extensive review of the medical literature regarding the increased risk of cardiovascular and kidney disease that has been observed in various groups of HCV-infected patients. The potential link between such increased risk and the metabolic consequences of chronic HCV infection has been explored. RESULTS According to a systematic review with a meta-analysis of longitudinal studies (n = 9 clinical observational studies; n = 1,947,034 unique patients), we found a strong relationship between positive anti-HCV serologic status and increased incidence of chronic kidney disease in the adult general population, the summary estimate for adjusted hazard ratio was 1.43 (95% confidence intervals, 1.23; 1.63, P = 0.0001) (random-effects model) in anti-HCV positive patients. In another meta-analysis of clinical observational studies (n = 145,608 unique patients on long term dialysis; n = 14 observational studies), anti-HCV sero-positive status was an independent and significant risk factor for death in patients on maintenance dialysis. The summary estimate for adjusted relative risk (all-cause mortality) was 1.35 with a 95% confidence interval (CI) of 1.25; 1.47 (P < 0.01) in anti-HCV positive patients on maintenance dialysis. An updated and stratified analysis (n = 4 studies, n = 91,916 patients on maintenance dialysis) resulted in an adjusted HR for cardiovascular mortality among anti-HCV positive patients of 1.21 (95% CI, 1.06; 1.39) (P < 0.01); the homogeneity assumption was not rejected. The mechanisms underlying such relationships remain unclear; it has been suggested that HCV promotes atherogenesis through direct and indirect mechanisms. CONCLUSIONS Clinical trials are under way to assess whether the clearance of HCV RNA from serum by direct-acting antiviral drugs reduces all cause or disease-specific (cardiovascular) mortality among patients on maintenance dialysis.
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Affiliation(s)
- Fabrizio Fabrizi
- Division of Nephrology, Maggiore Hospital and IRCCS Foundation. Milano, Italy
| | - Francesca M Donato
- Division of Gastroenterology, Maggiore Hospital and IRCCS Foundation. Milano, Italy
| | - Piergiorgio Messa
- Division of Nephrology, Maggiore Hospital and IRCCS Foundation, University School of Medicine. Milano, Italy Division of Nephrology, Maggiore Hospital and IRCCS Foundation. Milano, Italy
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Luma HN, Halle MP, Eloumou SAFB, Azingala F, Kamdem F, Donfack-Sontsa O, Ashuntantang G. Seroprevalence of human immunodeficiency virus, hepatitis B and C viruses among haemodialysis patients in two newly opened centres in Cameroon. Pan Afr Med J 2017; 27:235. [PMID: 28979637 PMCID: PMC5622837 DOI: 10.11604/pamj.2017.27.235.13121] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 07/16/2017] [Indexed: 12/16/2022] Open
Abstract
Introduction Haemodialysis (HD) patients are potentially susceptible to infection with blood borne viral agents especially; Human Immunodeficiency Virus (HIV), hepatitis B (HBV) and hepatitis C Viruses (HCV), compared to the general population. We described their epidemiology in two newly created haemodialysis units in Cameroon: the Buea and Bamenda haemodialysis centres. Methods A cross sectional study: included were patients who had spent at least three months in haemodialysis. HBV, HCV and HIV serologies were determined and patients' characteristics extracted from patient's records. Results We included 104 participants (44 in Buea and 60 in Bamenda). Mean age was 48 years and 65.4% were men. Median duration in dialysis was 14 months. One of the three viral markers was present in 40.1% of patients. The hepatitis B surface antigen, anti-HCV and anti-HIV antibody prevalence were respectively 10.6%, 19.2%, 13.5%. A history of sexually transmitted infection was the only variable associated with anti-HIV antibody positivity Conclusion The sero-prevalence of HBsAg, HCV and HIV are high in the two centres. HIV prevalence may have reflected its etiology as a cause of ESKD. HCV remains a cause for concern and needs further evaluation. There is urgent need for the implementation of preventive and control measures.
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Affiliation(s)
- Henry Namme Luma
- Internal Medicine Service, Douala General Hospital, Douala, Cameroon.,Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
| | - Marie Patrice Halle
- Internal Medicine Service, Douala General Hospital, Douala, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Servais Albert Fiacre Bagnaka Eloumou
- Internal Medicine Service, Douala General Hospital, Douala, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | - Felicite Kamdem
- Internal Medicine Service, Douala General Hospital, Douala, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | - Gloria Ashuntantang
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé, Yaoundé, Cameroon
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