Prevalence and associations of hepatitis C viremia in hemodialysis patients at a tertiary care hospital

Abstract

Hepatitis C virus (HCV) infection in hemodialysis (HD) is a significant problem. We evaluated the prevalence and associations of HCV viremia in our HD patients. All patients undergoing maintenance HD at our center were tested for HCV RNA by PCR after written informed consent. Detailed history regarding age, sex, and duration of dialysis, frequency of dialysis, blood transfusions in one year, number of dialysis centers, dialyzer reuse/fresh use, and recent laboratory data was recorded. A total of 119 patients (77 males and 42 females) were tested for HCV RNA. Thirty three (27.7%) tested positive. Duration of dialysis was significantly longer in HCV RNA positive group (P = 0.001). 45.2% of patients with duration of dialysis more than 16 months were HCV RNA positive while only 7.4% of patients with dialysis duration ≤16 months were HCV RNA positive (P < 0.001). In univariate analysis, in HCV RNA group patients, ALT, AST, and GGTP were significantly elevated and albumin was significantly lower. 39% of patients who had dialysis at more than one center were HCV RNA positive as compared to 20% for patients undergoing dialysis at single center (P = 0.024). Binary logistic regression analysis showed albumin, duration of dialysis, and serum ALT to be significant variables. Sensitivity and specificity of anti-HCV ELISA was 72.7 and 97.7%, respectively. Prevalence of HCV RNA in the HD population is 27.7%. Duration of dialysis, getting dialysis at more than one center, elevated transaminase levels, and low serum albumin are important associations for HCV RNA positivity.

Profile of Hepatitis B Virus, Hepatitis C Virus, Hepatitis D Virus and Human Immunodeficiency Virus Infections in Hemodialysis Patients of a Tertiary Care Hospital in Uttarakhand

“…17,18 In our study, anti-HCV antibodies were found in 30.5% of patients at the end of 18 months of our study period, which is lower than studies conducted by Chandra et al (46%) 19 but was higher than studies conducted by Jain (29%) 20 and Jasuja (22%). 21 Our hospital is a tertiary care center where many patients are referred for HD from other HD centers of Uttarakhand and patients registered at our center did take HD at other centers as per their convenience. Out of 17 patients seroconverting for anti-HCV antibodies, 10 gave history of receiving HD at some other dialysis center.…”

Tackling the Hepatitis C Disease Burden in Punjab, India

“…15 In a study from New Delhi, 119 patients undergoing HD were enrolled and the prevalence of HCV RNA positivity was found to be as high as 27.7%. 16 The prevalence of HCV infection in renal transplant recipients in India has been reported to be as high as 26.2-55.9%. 17 The prevalence of HCV infection in HCWs has ranged from 0% to 4%, and is notably higher among staff working in HD units.…”

Prevalence and Risk Factors of HCV Infection among Haemodialysis Patients at Dialysis Centers in Khartoum State - Sudan

“…The prevalence of HCV infection in patients undergoing dialysis is persistently greater than that in the general population being endemic in haemodialysis (HD) units around the world, predominantly in Mediterranean and developing countries of the Middle and Far East. Nosocomial transmission of HCV infection has been reported to be a considerable route in modern hospital dialysis units, particularly during the outbreaks of infection [1][2][3][4][5][6].…”