Hepatitis B and C virus infection among hemodialysis patients in yogyakarta, Indonesia: Prevalence and molecular evidence for nosocomial transmission

Abstract

Hemodialysis patients are at an increased risk of acquiring hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. However, the prevalence of hepatitis viral infection and its genotype distribution among hemodialysis patients in Indonesia are unclear. In order to investigate these issues and the possibility of nosocomial transmission, 161 hemodialysis patients and 35 staff members at one of the hemodialysis unit in Yogyakarta, Indonesia, were tested for serological and virological markers of both viruses. HBV surface antigen (HBsAg) was detected in 18 patients (11.2%) and in two staff members (5.7%). Anti-HCV was detected in 130 patients (80.7%) but not in any staff members. Occult HBV and HCV infection were detected in 21 (14.7%) and 4 (12.9%) patients, respectively. The overall prevalence rates of HBV and HCV infection among patients were 24.2% and 83.2%, respectively. HCV infection was independently associated with hemodialysis duration and the number of blood transfusions. Phylogenetic analysis revealed that 23 of 39 tested HBV strains (59%) were genotype B, 11 (28.2%) were genotype C, and 5 (12.8%) were genotype A. HCV genotype 1a was dominant (95%) among 100 tested HCV strains. Nosocomial transmission was suspected because the genotype distribution differed from that of the general population in Indonesia, and because the viral genomes of several strains were identical. These findings suggest that HBV and HCV infection is common among hemodialysis patients in Yogyakarta, and probably occurs through nosocomial infection. Implementation of strict infection-control programs is necessary in hemodialysis units in Indonesia.

High Rates of Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus Infections and Uncommon HBV Genotype/Subtype and HCV Subtype Distributions among Transgender Individuals in Surabaya, Indonesia

“…Our previous report revealed that ＞90z of samples obtained from the general population, chronic liver disease patients, and patients on maintenance hemodialysis in Surabaya belong to the genotype B and subtype adw (13); this finding is similar to the results found in other parts of Java Island (10,25), and the genotype/ subtype C/adrq ＋ was mostly found in the most eastern region of Indonesia (in the Papuan ethnic group) (9,25,28). This study showed at least 30z of the samples (3/9) were of C/adrq ＋ , and 2 of them were from Maduranese individuals.…”

“…HBV isolates of different genotypes and subtypes show different geographical distributions, virological characteristics, and possibly, clinical outcomes (9,10). Genotypes B and C (HBV/B and HBV/C, respectively) are predominant in Asia and particularly, in Indonesia (11,12).…”

Prevalence of hepatitis B and C virus infections in hemodialysis patients in Vietnam: A systematic review and meta‐analysis

“…Hemodialysis is being decentralized across Vietnam into district and provincial centers where adherence to infection prevention and control policy and guidelines associated with HBV and HCV may be suboptimal. 39 Yet, our national pooled HBV and HBV and HCV coinfection rates were higher than rates in low-resource regions outside Asia, such as Libya where the rates were lower for HBV (2.6%, 95% CI 2-3.3%) and HBV and HCV coinfection (1.2%, 95% CI 0.9-1.7%). [34][35][36][37] The move away from anti-HCV toward HCV-coreAg screening is based on the need for accuracy, with experts suggesting that, while the nucleic acid testing (NAT) technique is superior to anti-HCV, it should be replaced with HCV-coreAg for routine monitoring of chronic hemodialysis patients because HCV-coreAg is more cost-effective, less labor-intensive, and comparable for accuracy.…”

High Incidence of Hepatitis B Virus Infection in Hemodialysis Patients at Sanglah General Hospital and It’s Risk Factors

“…22 Several studies have also been performed in Indonesia, studies were conduct in West Java and Yogyakarta, they report that the prevalence of HBV infection in HD patient were 6.8% and 11.2%. 13,14 Some countries have different policies regarding blood transfusions and the use of special machines HD in patients with HBV infection are becoming some factors that in uence in the transmission of HBV. In some developed countries, precautions HBV infection during blood donation and when initation of HD might have been better than the developing countries.…”