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Factors Associated with Seroconversion of Hepatitis C Virus in End Stage Renal Disease Patients
Muhammad Anees1, Nosheen Sarwar1, Sajad Ahmad1
1Department of Nephrology, King Edward Medical University, Lahore, Pakistan.
Insights
Hepatitis C virus (HCV) seroconversion is high in hemodialysis patients. Surgical intervention, dental procedures, blood transfusions, and poor infection control significantly increase HCV risk during dialysis.
Area of Science:
- Nephrology and Virology
- Infectious Disease Epidemiology
Background:
- Hepatitis C virus (HCV) poses a significant risk to patients undergoing hemodialysis (HD).
- Understanding factors contributing to HCV seroconversion in HD patients is crucial for implementing effective prevention strategies.
Purpose of the Study:
- To identify patient-specific and dialysis service-related factors associated with HCV seroconversion in hemodialysis patients.
- To assess the impact of infection control measures on HCV transmission within HD units.
Main Methods:
- A cross-sectional study was conducted involving 990 hemodialysis patients.
- Data collected included patient demographics, medical history (blood transfusions, dental/surgical procedures), and dialysis service parameters (infection control compliance).
Main Results:
- Nearly 50% of patients (49.7%) seroconverted for HCV. Significant risk factors included surgical intervention, dental procedures, blood transfusions, multiple sexual partners, age, and duration of dialysis.
- Non-compliance with universal infection control measures showed a significant negative correlation with HCV seroconversion rates.
Conclusions:
- A high rate of HCV seroconversion was observed in the studied hemodialysis population.
- Patient history (surgical, dental, transfusions) and adherence to infection control protocols are critical in preventing HCV transmission during dialysis.
Objective:
To determine patient and dialysis services-related factors associated with seroconversion of hepatitis C virus (HCV) in hemodialysis (HD) patients.
Study Design:
Cross-sectional study.
Place And Duration Of Study:
Department of Nephrology, Mayo Hospital, King Edward Medical University (KEMU), Lahore, from January to December, 2018.
Methodology:
All patients on regular HD for more than three months were enrolled. All patients who seroconverted from HCV-negative to positive status three months after starting HD, were included. Patient-related factors (age, gender, blood transfusion, duration and frequency of dialysis, history of dental treatment and surgical intervention) and dialysis services-related parameters (dedicated staff, isolated room, hemodialysis machine, reverse osmosis plant, compliance of universal infection control measure) were noted.
Results:
Out of 990 patients, 492 (49.7%) were reported as seroconverted for HCV during HD. Factors determined statistically significant for seroconversion were surgical intervention (p<0.001), history of dental procedure (p <0.001), blood transfusions (p <0.001), multiple sexual partner (p <0.001), age (p=0.035) and duration of hemodialysis (p <0.001). Factors not affecting seroconversion included frequency of dialysis (p=0.062), history of renal transplant (p =0.097) and family history of hepatitis (p=0.941). A significant negative correlation was observed between the rate of seroconversion of HCV and the score of universal infection control measures (r=-0.665, p=0.018).
Conclusion:
There was a high rate of seroconversion of HCV in HD patients. Factors responsible for seroconversion were history of surgical intervention, dental treatment, blood transfusion, multiple sexual partners, age and duration of dialysis. The dialysis centres non-compliant with universal infection control measures were having high rate of seroconversion. Key Words: Hemodialysis, Seroconversion, HCV, Blood transfusion, Dental treatment, Surgical intervention, Infection, Isolation.
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