Seroprevalence of Hepatitis B and C Viruses in Patients with Chronic Kidney Disease in the Predialysis Stage at a University Hospital in Turkey

Abstract

Background: Hepatitis B (HBV) and C (HCV) viruses are the most common viruses that cause viral infections among the hemodialysis patients. Objectives: To assess the prevalence of HBV and HCV in predialytic chronic kidney disease (CKD) patients. Design: A cross-sectional study. Subjects: 171 consecutive predialytic CKD patients. Measurements: Third-generation micro-ELISA assay was used for hepatitis B surface antigen (HBsAg), antibody to hepatitis B core (anti-HBc) and surface antibody (anti-HBs), secretory form of hepatitis B envelop antigen (HBeAg), antibody to secretory form of hepatitis B envelop antigen (anti-HBe), and ELISA for antibody to hepatitis C virus (anti-HCV). Results: The main causes of CKD were 29.8% diabetic nephropathy, 19.9% chronic glomerulonephritis, 16.3% hypertensive nephrosclerosis, 14.0% unknown, 5.3% amyloidosis, 4.7% autosomal-dominant polycystic kidney disease, 4.1% chronic tubuluointerstitial nephritis, 3.5% malignancies, 1.7% benign prostatic hypertrophy, 0.6% Alport syndrome. The seroprevalence of hepatitis was: HBsAg 10.5%, anti-HBc 36.8%, anti-HBs 28.7%, HBeAg 5.3%, anti-HBe 32.7%, anti-HCV 7% and HBsAg+anti-HCV 0.6%. Conclusions: The seroprevalence of HBsAg and anti-HCV among predialytic CKD patients was similar to our patients in hemodialysis program.

Seroprevalence of Anti-HCV Antibody in Patients with Chronic Kidney Disease before Starting Dialysis Therapy

“…40 In Turkey, in predialysis and hemodialysis patients prevalence of anti-HCV was 7% and 19.3% respectively and coexistence of positive HBsAg and anti-HCV was 0.6% and 1.5% r e spectively in different studies. 17,41 In Bangladesh, around 71% of patients on maintenance hemodialysis were serologically positive for hepatitis C virus infection. 42 …”

“…A very few studies are available regarding prevalence of HCV in CKD patients before dialysis. 17 In this study it has been attempted to determine the prevalence of anti-HCV antibody in the predialysis CKD patients, which will help in the development of awareness and stringent screening procedure to reduce the transmission of infection.…”

Seroprevalance of the Hepatitis B and C in Patients with Chronic Kidney Disease without History of Renal Replacement Therapy

“…where HBV and HCV infections occur more frequently (13). In the study by Fabrizi et al, in Milano, Italy between 1995-1999, HBsAg and Anti-HCV seroprevalence in CKD patients without RRT were found to be 3.7% and 11.5% respectively (14).…”

“…In addition, it is known that, HCV infection occurs more commonly in CKD and is associated with an increase in the risk of end stage renal disease (15,22). It is proposed that the risk of exposure to HBV and HCV increases in CKD due to impaired humoral and cellular immune response, blood transfusion, immunosuppressive drug use and inadequacy in basic protection measures in hemodialysis units (7,(12)(13)(14). Through measures taken in recent years (serological virus screening in patients, evaluation of viral serology in blood product donors, decreasing the need for transfusion by using erythropoiesis stimulating agents, vaccination against HBV and basic infection control precautions) a decrease in HBV and HCV prevalence was reported in patients receiving renal replacement therapy in our country, and in the rest of the world (11).…”

“…As far as we know, there are few studies on this subject (13)(14)(15). It is not clearly known whether high HBV and HCV seroprevalance in CKD population receiving RRT stems from predialysis or pretransplantation period.…”