Hepatitis B and C infection in haemodialysis patients in Libya: prevalence, incidence and risk factors

Abstract

BackgroundPatients 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.MethodsAll 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.ResultsParticipant 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.ConclusionPatients 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.

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

“…This is in line with that was found: In Sudan, HCV seropositivity was significantly associated with dialysis in multiple centers [29]. In Libya, a study showed that HBV or HCV infection was associated with a history of HD in another centre either in Libya or abroad [24].…”

Prevalence of Hepatitis B and Hepatitis C Infection among Patients Undergoing Dialysis

“…It seems an important contributing factor for spread of hepatitis. A similar correlation was observed between HBV or HCV marker positivity and the number of patients treated per haemodialysis unit [2].…”

“…It depends on patient's requirement. Due to multiple practices of dialysis, these patients are more prone to HCV and HBsAg infection [2].…”

The Prevalence of HIV, HCV, and HBV Among Hemodialysis Patients Attending Duhok Hemodialysis Center

“…In a previous study on 8615 adult hemodialysis patients from 308 dialysis centers in Western Europe and the United States, the prevalence of HBV infection ranged from 0% to 6.6% (13). In developing countries, the prevalence of HBV infection varies from 2% to 20% in patients with hemodialysis (14)(15)(16).…”

“…In 2 studies conducted in Saudi Arabia and Jordan, two neighboring countries of Iraq, the prevalence of HBV in renal dialysis patients was 4.6% and 5.9%, respectively (16,17). In our study, we found that 3.2% of subjects were HBsAg positive.…”