Hepatitis C Viral Prevalence and Seroconversion in Moroccan Hemodialysis Units: Eight Year Follow Up

Abstract

Introduction: The prevalence of Hepatitis C Virus (HCV) in chronic hemodialysis patients is eight times higher than among the general population. It is estimated between 3 and 65.8% in different studies and countries and is a contributor to mortality in this population. The aim of this study is to define the factors influencing prevalence and seroconversion of HCV in an ambispective study including 15 centers and 163 hemodialysis patients.Methods: Multicenter ambispective Study including 167 patients treated in 15 dialysis centers in 4 cities and over a period of 8 years. In 2002, all patients underwent determination of liver enzymes, a serological survey and qualitative research of HCV RNA by polymerase chain reaction followed by a genotyping for patients confirmed positive by the method LIPA. Serological status and movement of patients between centers was followed for 8 years. In 2010, the survivors benefit serology of viral hepatitis B and C (4 th generation ELISA) with research of viral RNA by PCR. Results:The mean age of patients at baseline was 51 years of which 11% were diabetic with a mean of 55 months on hemodialysis. The prevalence of HCV was 33.4% with significantly higher ALT in positive patients and genotype 1b was most frequent (54%). Statistical analysis found that the factors of prevalence are: time on hemodialysis, number of units visited (2.2 vs. 3, p<0.001), number of red blood cells transfused (1.5 vs. 2.5, p=0.009) and area of the unit. After 8 years, overall survival was 58.2% with a prevalence of HCV at 26.2%. During follow-up, 7 seroconversion were objectified and the only factor found is the number of centers visited.Conclusions: These data suggest that nosocomial transmission plays an important role hence the importance of strict implementation of the recommendations of prevention against the transmission of HCV in particular the training of personnel and control the transfer of patients between centers.Keywords: Hemodialysis; Hepatitis C virus; Prevalence; Seroconversion Introduction:Hepatitis C virus (HCV) infection represents a big public health challenge in this millennium and the World Health Organization estimates that, until 1998, 170 million people carried the HCV worldwide and in recent years 200 million or 3% of the world population is infected with this virus [1]. Low prevalence is reported in Europe and North America, while it's high in the Far East and Africa where the prevalence exceeds 10% in Egypt. In Morocco, a recent study showing that among the 8326 samples tested by third generation ELISA, 161 samples were positive, so a prevalence of 1.93% [2].In dialysis the problem is much broader, with a prevalence that can reach 80% and an incidence of more than 9% per year [3][4][5][6]. To this is added a high mortality in hemodialysis patients infected with HCV according to many authors [7][8][9][10]. In Morocco it is estimated that the prevalence of hepatitis C virus in dialysis is 32% according to the National Register "MAGREDIAL [4]. But this rate varies widely amon...

Hepatitis C Virus in North Africa: An Emerging Threat

“…HCV is a major problem in hemodialysis centers in Morocco. A multicenter study covering different Moroccan dialysis centers found that the prevalence varied from 11% to 91% [33]. …”