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Hepatitis C prevalence and risk factors in the northern Alberta dialysis population
J Sandhu1, J K Preiksaitis, P M Campbell
1Department of Public Health Sciences, University of Alberta, Edmonton, Canada.
Insights
Hepatitis C virus (HCV) infection affects 6.5% of renal dialysis patients in Alberta. Key risk factors include age, duration of dialysis, and lifestyle behaviors, not transfusions before 1990.
Area of Science:
- Hepatology
- Infectious Diseases
- Nephrology
Background:
- Hepatitis C virus (HCV) poses a significant global health challenge, particularly for patients requiring renal dialysis.
- Multiply transfused renal dialysis patients are a vulnerable group for HCV infection.
Purpose of the Study:
- To determine the prevalence of HCV infection in renal dialysis patients in northern Alberta, Canada.
- To identify risk factors associated with HCV infection in this specific patient population.
Main Methods:
- A cross-sectional study involving 336 renal dialysis patients in northern Alberta.
- Data collected through interviews for risk factor assessment.
- Multiple logistic regression analysis with exact inference used to develop a predictive model for HCV infection.
Main Results:
- The prevalence of HCV infection was found to be 6.5% among the studied patients.
- Identifiable risk factors were present in all positive cases.
- Increased risk was associated with age (18-55 years), dialysis duration (> 5 years), and multiple high-risk lifestyle behaviors (≥ 2).
- Transfusion prior to 1990 showed a marginal association with HCV status.
Conclusions:
- Previously unreported lifestyle risk factors for HCV infection in renal failure patients were identified.
- A decline in transfusion-acquired HCV infection was confirmed in this population.
- Evidence suggests a lack of significant nosocomial transmission of HCV among these patients.
Abstract:
Hepatitis C virus (HCV) is an emerging global public health issue with particular relevance in multiply transfused renal dialysis patients. This cross-sectional study evaluated the prevalence and risk factors for HCV infection among renal dialysis patients in northern Alberta, Canada. Ninety-two percent of eligible patients (n = 336) provided informed consent to participate. Participants were interviewed to gather risk factor information and, using multiple logistic regression analysis with exact inference, a predictive model for HCV infection in this population was developed. The prevalence of HCV infection in the population was 6.5%, and all positive patients had at least one identifiable risk factor. The multivariate analysis showed that the risk of HCV infection was greater for those in the 18-55 years age category (odds ratio (OR) = 4.9, 95% confidence interval (CI) 1.2-27.9), patients who had been on dialysis > 5 years (OR = 3.7, 95% CI 1.2-12.0), and patients who had > or = 2 high risk life-style behaviors (OR = 5.0, 95% CI 1.5-16.7). Transfusion prior to 1990 was marginally associated with HCV status (OR = 4.0, 95% CI 0.96-16.3). This study documented previously unreported life-style risk factors for HCV infection in patients with renal failure, confirmed the expected decline in transfusion-acquired HCV infection in this population, and provided evidence against nosocomial transmission of HCV.