Hepatitis B Infection in Hemodialysis Patients in Tehran Province, Iran

Background and Aims: Hemodialysis (HD) patients seem to be at considerable risk of acquiring HBV infection. This study was carried out to determine the seroprevalence of hepatitis B virus (HBV) infection in hemodialysis patients living in the province of Tehran and to investigate the association between viral hepatitis B and the probable risk factors for HD patients.

Methods: From June to August 2005, this study was done on the entire HD population of the province of Tehran (2630 patients; 1505 males and 1125 females, mean age: 53.4 years). Social and demographic data, date of onset of HD, length of time receiving HD services, history of a kidney transplant, multiple sex partners, and other probable risk factors were evaluated. Blood samples were tested for liver enzyme levels as well as human immunodeficiency virus (HIV) 1, HIV 2, hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis C antibody (anti-HCV).

Results: A total of 64 patients were HBsAg positive (2.4%). The male-to-female ratio was 45/19 for HBsAg-positive patients and 1462/1104 for the remaining patients (P = 0.03), respectively. Except for nationality (P < 0.001), previous kidney transplants (P < 0.001), age (P < 0.001), and transient HD (P < 0.001), no association was found between HBV infection and probable risk factors.

Conclusions: Common erythropoietin administration, blood testing for transfusion purposes, implementation of universal precaution in dialysis units as well as the use of dedicated machines for HBV-infected patients has led to a decreasing trend of HBV infection. Periodic surveillance of HBV infection among patients undergoing hemodialysis is strongly recommended.