Incidence and prevalence of hepatitis B and hepatitis C viruses in hemodialysis patients in Lebanon

Abstract

AIM:To determine the incidence and the prevalence of hepatitis B and C viral infections in patients on hemodialysis (HD) across Lebanon. METHODS:We reviewed the data registry at the Lebanese Ministry of Public Health where records of monthly hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) serology are reported from 60 affiliated HD centers across Lebanon. All patients who were on HD or who started HD between October 2010 and July 2012 were included in the study. Patients from seven HD centers were excluded due to inadequate and incomplete results reporting. During the selected Retrospective Study ORIGINAL ARTICLEperiod, HBsAg and HCV serology were available for 3769 patients from 53 HD centers distributed at all Lebanese governorates. The prevalence was calculated by dividing the number of patients with positive HBsAg or HCV serology to the total number of patients. The Incidence was calculated by dividing the number of newly acquired infection to number of patients-years (p-y). Incidence rates at different governorates were compared to each other using two tailed Z test and a P value of < 0.05 was considered significant. RESULTS:Sixty out of 3769 HD patients were found to have positive HBS Ag and 177 out of 3769 were positive for HCV Antibodies. The prevalence of hepatitis B virus (HBV) and HCV in HD patients across Lebanon was 1.6%, and 4.7%, respectively. The comparison of prevalence according to geographic distribution could not be done accurately due to the frequent shift of patients between dialysis centers at different governorates. The incidence rate was 0.27 per 100 p-y for HBV and 0.37 per 100 p-y for HCV. There was no significant difference concerning the incidence of HBV between HD centers at different governorates (all P values > 0.1), but this difference was highly significant concerning the incidence rates of HCV which occurred predominantly in the southern centers (1.47 per 100 p-y) with a P value of 0.00068 and 0.00374 when compared to Mount Lebanon (0.21 per 100 p-y) and the Northern centers (0.19 per 100 p-y), respectively. CONCLUSION:The incidence rate of HBV and HCV is very low in the Lebanese HD centers and their prevalence is decreasing over the last two decades.

The epidemiology of HCV infection in patients with advanced CKD/ESRD: A global perspective

“…This is partly explained by fewer studies in the medical literature, most of which have limited sample sizes (typically single‐center studies). The prevalence rates observed in these countries remain much higher than those noted in the developed world with prevalence rates between 4.7% and 41.9%, as shown in Table . The higher diffusion of HCV among patients receiving regular dialysis in less‐developed countries is attributed to various factors including incomplete infection control processes and procedures against HCV within dialysis units, as well as a higher prevalence of HCV in the respective general populations.…”

Epidemiology of hepatitis C virus among hemodialysis patients in the Middle East and North Africa: systematic syntheses, meta-analyses, and meta-regressions

“…Incidence varied extensively even within the same country. For example, in Lebanon, HCV incidence rate varied from 0 to 14·7 per 1000 person-years across different geographical sites [120].…”

Prevalence of anti-hepatitis E virus IgG antibodies in sera from hemodialysis patients in Tripoli, Lebanon

“…HEV prevalence among HD patients was previously reported in several Mediterranean countries (Table 2). In contrast, in Lebanon, while recent data concerning the prevalence of hepatitis B and C viruses among national HD patients are available [17], there is no data regarding HEV epidemiology in this population. Thus, our study is the first national report dealing with this subject.…”