Non-A, non-B hepatitis in hemodialysis

Area of Science:

• Hepatology
• Infectious Diseases
• Nephrology

Background:

• Hepatitis B virus (HBV) and hepatitis A virus (HAV) infections are significant concerns in hemodialysis patients.
• Previous epidemiological data in these centers indicated a different pattern of viral hepatitis prevalence.

Purpose of the Study:

• To determine the prevalence of hepatitis A and B markers in hemodialysis patients and their contacts.
• To investigate the incidence of non-A, non-B hepatitis episodes over a two-year period.
• To assess secondary infections, including cytomegalovirus (CMV) and Epstein-Barr virus (EBV), in household contacts.

Main Methods:

• Commercial radioimmunoassay (RIA) kits were used to detect hepatitis A and B markers.
• Enzyme-linked immunosorbent assay (ELISA) techniques identified IgM-anti-CMV and IgM-anti-EBV.
• The study included 154 dialysis patients, 118 relatives, and 42 staff members.

Main Results:

• HBV markers were highly prevalent: 71% in center dialysis patients, 63% in home dialysis patients, 50% in staff, and 19% in relatives.
• Spouses of patients showed higher HBV marker positivity than other relatives.
• Hepatitis A virus (HAV) antibodies were prevalent (98.8% in center patients, 83.3% in home patients).
• Cytomegalovirus (CMV) IgM was notably present in 15.5% of home dialysis patients.
• Nine percent of all dialysis patients experienced presumed non-A, non-B hepatitis episodes during the study.

Conclusions:

• A significant change in hepatitis epidemiology has occurred within these hemodialysis centers.
• Hemodialysis patients exhibit high rates of HBV and HAV seropositivity.
• The study highlights the ongoing challenge of viral hepatitis in the hemodialysis population.