[Study on risk factors of hepatitis B virus infection among patients receiving hemodialysis by multi-level...

To understand the current status of HBV infection among patients receiving maintenance hemodialysis (MHD) and related influencing factors.

A questionnaire survey was conducted among 1,524 MHD patients selected from hemodialysis units in 16 hospitals in Shanxi province from 1 November 2012 to 30 December 2014 to collect their demographic information and learn about their risk behaviors. Serological detection was conducted for them. Statistical software package SAS 9.3 was used for fitting a two level logistic regression model to identify the independent risk factors for HBV infection.

Among the 1 524 MHD patients, the positive rate of HBsAg was 5.25% and the HBV infection rate was 38.85%. The HBV infection rate varied with hospital (t=2.33, P=0.034). The two-level logistic regression empty model showed that intra-class correlation coefficient was 0.106 4, indicating that about 10.64% of the total variation was caused by the differences in hospitals. After introducing explaining variables, the results showed that the HBV infection rate in age group 50-65 years group was higher than that in age group 0-35 years (OR=1.560, 95% CI: 1.061-2.293). Family history of HBV infection and dental surgery were the risk factors for HBV infection (OR=2.052 and 1.267, 95% CI: 1.176-3.582 and 1.009-1.591). Receiving HepB vaccination was a protective factor for HBV infection (OR=0.734, 95% CI: 0.541-0.996).

The HBV infection rates were different among MHD patients in different hospitals. Old age (50-65 years), family history of HBV infection and dental surgery were the risk factors and receiving HepB vaccination was a protective factor for HBV infection among MHD patients.