Prevalence of Hepatitis B, C Viruses Higher Among Individuals on Hemodialysis

The prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) was higher among individuals undergoing hemodialysis than among the general population, according to the results of a study published in Cureus.

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Investigators also noted that a significant proportion of patients had negative HBV surface antibody (anti-HBs) titers, which indicated a need for vaccination and monitoring of these antibodies to ensure protection for patients.

In the retrospective study, investigators included all patients on hemodialysis who were dialyzed regularly at the Kano Kidney Center during 2022. Investigators reviewed electronic medical record to determine the incidence of HBV, HCV, and HIV, as well as the demographics, comorbid conditions, and dialysis history.

There were 239 individuals included in the study, with 142 males and 97 females. Most individuals were Saudis at 156 patients and the majority of non-Saudi patients were Arabian.

Investigators found that 9 patients tested positive for hepatitis B surface antigens (HBSAg), which they call “the serologic hallmark of HBV infection.” Two individuals had resolved HBV infections indicated by hepatitis B core antibody (anti-HBc) and anti-HBs.

However, the investigators found that 94.56% of patients were never tested for anti-HBc. Approximately 69.04% of patients were positive for anti-HBs, implying a long-term immunity against HBV either from prior infection or vaccination.

A protective anti-HBs level of 10 IU/L or greater was detected in 158 individuals with 104 patients having 100 IU/L or greater.

For HCV, 18 patients had reactive antibodies with 4 had chronic HCV infections with detectable HCV RNA. The remaining 14 individuals had cleared HCV with 7 being spontaneously and 7 by medication. All individuals tested negative for HIV.

Investigators found that there were no significant differences between HBsAg-positive or negative patients. However, patients who were positive for HCV antibodies were older than the individuals who were negative for HCV antibodies, with an average of 60 years and 52 years, respectively.

Additionally, there was a statistically larger proportion of patients who were positive for HCV antibodies who were non-Saudi than with no evidence of prior infections at 61.11% and 32.13%, respectively. Investigators determined that the prevalence of HBV and HCV infections among hemodialysis patients was 3.77% and 1.67%, respectively, which was higher than the general population in Saudi Arabia.

The study authors listed several limitations, including the nature of the research. The study was retrospective, which they said could lead to potential biases due to inaccurate documentation and missing information. Investigators also said that some of the information on infection status could have changed due to the screening results being 1 year old. Additionally, the generalizability of the results is limited due to data from a single center.

Investigators called for future studies to research the limitations for a more accurate representation of the prevalence and incidence of HBV, HCV, and HIV infection in hemodialysis patients.

Reference

Alkhalifah RH, Alhaddad MJ, Alhashem AT, Alwesaibi H, et al. Prevalence of hepatitis B virus, hepatitis C virus, and HIV infections in hemodialysis patients at Kano Kidney Center. Cureus. 15(7):e41769. doi:10.7759/cureus.41769