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National Epidemiological Study about Hepatitis C Virus Infection among Dialysis Patients
Meriam Hajji1, Samia Barbouch1, Rihab Manaa2
1Department of Medicine A; Laboratory of Renal Pathology LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia.
Insights
Hepatitis C virus (HCV) infection is prevalent in dialysis patients, with a 3.6% prevalence found in this study. Seroconversion rates were lower than previously reported, suggesting improved infection control measures.
Area of Science:
- Nephrology
- Infectious Diseases
- Epidemiology
Background:
- Hepatitis C virus (HCV) is a significant concern in dialysis patients, increasing risks for cirrhosis and hepatocarcinoma.
- The World Health Organization estimates 3% of the general population has HCV, but prevalence is higher in renal disease populations.
Purpose of the Study:
- To determine the prevalence of HCV in dialysis patients nationwide.
- To calculate the rate of HCV seroconversion in this cohort.
- To identify risk factors associated with HCV seroconversion.
Main Methods:
- A nationwide, multicenter, observational study included 11,238 dialysis patients from 185 centers (176 hemodialysis, 9 peritoneal dialysis).
- Data collected included patient demographics, HCV status, and center characteristics.
- HCV seroconversion was monitored over time.
Main Results:
- The overall prevalence of HCV-positive patients was 3.6%, higher in private (2.7%) versus public (1.18%) centers (P = 0.009).
- HCV prevalence was significantly higher in hemodialysis versus peritoneal dialysis centers, in centers with >15 generators, and those with >70 patients.
- A seroconversion prevalence of 1.3% was observed, with a mean delay of 6.05 years.
Conclusions:
- HCV prevalence in dialysis patients is significant, with variations based on center type and size.
- The observed HCV seroconversion rate is lower than previously reported, potentially indicating effective infection control.
- Further national surveys with standardized diagnostics and treatment are recommended to eradicate HCV in dialysis patients.
Abstract:
The World Health Organization estimates that 3% of the general population is infected with this virus. Hepatitis C remains the main viral infection in dialysis patients, and the severity of this infection is the risk of developing cirrhosis or hepatocarcinoma. We aim to determine the prevalence of hepatitis C in dialysis patients, to calculate the rate of hepatitis C virus (HCV) seroconversion, and to identify the risk factors for seroconversion. This is a nationwide multicenter observational study including all dialysis patients regardless of age and gender. Those with acute renal failure and vacationers were excluded from the study. We included 185 centers including 176 hemodialysis (HD) centers and nine peritoneal dialysis (PD) centers with a total number of patients at 11,238, a number of HCV-positive patients at 402, and a number of functional machines at 3139. The mean age of a patient was 55.6 years (range: 18-65), and sex ratio was 0.9. The prevalence of HCV-positive patients is 3.6%; it is higher in private centers with an average of 2.7 compared to 1.18 in public centers with a significant difference (P = 0.009). The prevalence of HCV-positive patients was significantly higher in HD centers compared to PD centers, in centers where the number of generators was >15 and when the number of patients per center is >70. One hundred and fifty-six patients seroconverted after dialysis, i.e., a prevalence of seroconversion at 1.3% with a mean delay of 6.052 ± 5.3 years. Our study shows a lower prevalence of HCV seroconversion than that reported in the literature; this requires a national survey to be carried out by homogenizing virological diagnostic kits and treating infected patients to eradicate this infection in dialysis patients.
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