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

Abstract

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.

The prevalence of hepatitis C virus in hemodialysis patients in Pakistan: A systematic review and meta-analysis

“…The details and main characteristics of the 19 selected studies [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] are presented in Table 1. Twelve studies had used a cross-sectional research design, while seven studies did not explicitly specify their research design.…”

“…Multiple studies have reported the prevalence of HCV infection among hemodialysis patients in Pakistan [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. To the best of our knowledge, no official nationwide survey or national health registry has to date estimated the prevalence of HCV in hemodialysis patients in Pakistan.…”

Hepatitis B and C Infections in Patients With Prolonged Hemodialysis Secondary to Chronic Renal Failure

“…Our results are distressingly high as compare to previously mentioned results from other previous studies conducted in Pakistan. A study conducted in Karachi, Pakistan showed 10.2% of HD patients [15], another study conducted in Islamabad, Pakistan depicted 12.5% of HD patients [16], one study from Quetta showed 16.1% of HD patients found to be positive for HBV [17], these results were in contrast to 6% HBV positivity in general population of Pakistan [18]. All these studies also showed that the duration of dialysis was significantly correlated with positivity of HBV in HD patients similar to our findings.…”

Updated Evidence on the Epidemiology of Hepatitis C Virus in Hemodialysis

“…The information on prevalence and incidence rates of HCV among patients on regular dialysis in the emerging world is limited, and the most important survey to date has been given by the Asia-Pacific Dialysis Registry ( n = 201,590), which found that the prevalence of positive anti-HCV serologic status ranged between 0.7% and 18.1% across 10 various areas and regions [ 6 ]. Numerous single-center surveys from emerging countries have been published in the last decade, and these have reported high prevalence and incidence rates ( Table 1 ) [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ].…”