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. 2020 Jul-Aug;10(4):316-321.
doi: 10.1016/j.jceh.2019.11.002. Epub 2019 Nov 27.

Incidence and Risk Factors for Hepatitis C Virus and Hepatitis B Virus Seroconversion in End-Stage Renal Failure Patients on Maintenance Hemodialysis

Manik Kataruka  1 , Shefali Gupta  2 , Raja Ramchandran  1 , Mini Singh  3 , Radha Krishan Dhiman  4 , Kishan Lal Gupta  1
Affiliations

Incidence and Risk Factors for Hepatitis C Virus and Hepatitis B Virus Seroconversion in End-Stage Renal Failure Patients on Maintenance Hemodialysis

Manik Kataruka et al. J Clin Exp Hepatol. 2020 Jul-Aug.

Abstract

Background: Renal replacement therapy in the form of either dialysis or transplantation is the only option for end-stage renal disease (ESRD). Blood-borne infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV) are of special concern in these patients because of their high incidence. Although there are sufficient data from the developed world, there is scarcity of data from developing countries such as India.

Methods: All newly diagnosed ESRD patients initiated on hemodialysis after attending the Department of Nephrology, PGIMER, Chandigarh between January 2015 and October 2015 were included in the study. All the subjects were initially screened for HCV and HBV serology status and subsequent HCV and HBV status on follow-up at the end of 6 months and evaluated by standardized precoded questionnaires and biochemical examinations. Univariate and multivariate analyses were done to identify the risk factors for seroconversion.

Results: A total of 196 patients were recruited for the study after confirming seronegative status. At the end of 6 months, 61 patients lost to follow-up. Anti-HCV antibody had shown moderate association to HCV RNA testing at the end of 6 months by kappa test. Out of 135, 16.3% seroconverted to HCV RNA positive and 0.7% patient became hepatitis B surface antigen positive. Isolation of dialysis machine and nursing staff was associated with lower seroconversion.

Conclusion: In a real-life scenario, HCV seroconversion is observed in 15% of the patients initiated on hemodialysis. Isolation of both dialysis machine and personnel was associated with lower seroconversion.

Keywords: ALT, Alanine Aminotransferase; AST, Aspartate Aminotransferase; CKD, Chronic Kidney Disease; DAA, Direct-Acting Antiviral Disease; ESRD, End-Stage Renal Disease; HBV,, Hepatitis B Virus; HBsAg, Hepatitis B Surface Antigen; HCV, Hepatitis C Virus; end-stage renal disease; hemodialysis; hepatitis.

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Figures

Figure 1
Figure 1
Flow diagram of patient recruitment. HCV, Hepatitis C Virus; PCR, Polymerase Chain Reaction; CKD, Chronic Kidney Disease; ESRD, End-Stage Renal Disease; HBsAg, Hepatitis B Surface Antigen.
See this image and copyright information in PMC

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