Frequency of Hepatitis B and Hepatitis C Infections Among Patients With Chronic Kidney Disease: A Retrospective...

Background and objective Chronic hepatitis B virus (HBV) and chronic hepatitis C virus (HCV) infections are significant global public health challenges, affecting millions of individuals worldwide and contributing substantially to morbidity and mortality due to chronic liver disease and its complications. In Pakistan, the burden of viral hepatitis remains considerable, with HBV and HCV infections continuing to affect vulnerable populations and placing an additional healthcare burden on patients with chronic diseases, including chronic kidney disease (CKD). This study aimed to determine the frequency of both HBV and HCV infections separately among CKD patients and to evaluate their relationship with demographic and clinical factors in a local Pakistani population. Methods This retrospective data-based study was conducted at Chaudhary Muhammad Akram Teaching and Research Hospital (Lahore, PAK) and included 317 medical records of CKD patients aged ≥18 years who presented to the Department of Medicine and Nephrology for dialysis and ICU admission from January to December 2025. Incomplete medical records, patients with acute kidney injury, and records missing hepatitis serologies were excluded. A structured pro forma was used to extract demographic characteristics, CKD-related variables, and laboratory parameters including HBsAg and anti-HCV antibodies from patient medical records. Data were analyzed using SPSS Statistics version 23 (IBM Corp., Armonk, NY, USA).  Results Of the 317 CKD patients, 185 (58.4%) were male, and 184 (58.0%) resided in urban areas. Mean CKD duration was 2.9±2.8 years, with 185 (58.4%) having CKD for ≥2 years and 246 (77.6%) with stage 5 CKD. Hypertension was present in 271 (85.5%), diabetes in 171 (53.9%), and cardiovascular disease in 72 (22.7%). History of blood transfusion was reported in 140 (44.2%), while 214 (67.5%) had a history of dialysis. The mean hemoglobin (Hb) was 9.3±1.5 g/dL, with 247 (77.9%) having Hb>8 g/dL. Hepatitis B surface antigen (HBsAg) positivity was detected in 13 (4.1%) and anti-HCV in 131 (41.3%). Five (1.5%) had both HBsAg and anti-HCV positivity. Chi-square analysis revealed significantly associated anti-HCV positivity with the male gender (p<0.001), urban residence (p=0.038), CKD duration ≥2 years (p=0.027), advanced CKD stage (p<0.001), cardiovascular disease (p=0.049), blood transfusion history (p<0.001), and dialysis history (p<0.001). Binary logistic regression analysis demonstrated male gender (OR=0.483, 95% CI: 0.277-0.839; p=0.010), urban residence (OR=0.520, 95% CI: 0.305-0.887; p=0.016), positive history of blood transfusion (OR=0.348, 95% CI: 0.183-0.660; p=0.001), and dialysis history (OR=0.211, 95% CI: 0.091-0.488; p<0.001) to be predictors of anti-HCV positivity. Fisher's exact test demonstrated a significant association of HBsAg with the female gender (p=0.047) and diabetes (p<0.001). Regression analysis was not applied for HBsAg due to the limited number of participants with HBV positivity. Conclusion Hepatitis C virus was highly prevalent in CKD patients; HBV remained comparatively uncommon. This emphasizes the need for routine screening among CKD patients, especially those undergoing dialysis or receiving blood transfusions. Strengthening infection-control measures, ensuring safe transfusion practices, promoting HBV vaccination, and providing timely antiviral management may reduce the burden of viral hepatitis and improve clinical outcomes in this high-risk population.