Prevalence of Hepatitis B and C Infection in Hemodialysis Patients of Rasht (Center of Guilan Province, Northern Part of Iran)

Background and Aims: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are significant health problems, as they can lead to chronic active hepatitis, liver cirrhosis, and hepatic carcinoma. Factors associated with HBV propagation include blood and derivates transfusion, duration and frequency of hemodialysis, equipment contamination and contact among patients as well as between them and health-care workers. Transmission of HCV through dialysis units has shown a progressive increase worldwide, ranging from 5% in some western countries to 70% in some developing countries. The aim of this study was to determine the prevalence of HBV and HCV infections in hemodialysis patients of Rasht (center of Guilan province, North of Iran).

Methods: A cross-sectional analysis was performed on 163 chronic (>6 months) hemodialysis patients. Patients from the hemodialysis unit of Rasht were interviewed. The following data was collected: name, age, gender, occupation, duration of dialysis and cause of End Stage Renal Disease. Blood samples were collected and screened for HBsAg and anti-HCV antibodies by a third-generation enzyme-linked immunosorbent assay (ELISA). Qualitative HCV determination in ELISA positive cases (after two tests) was performed by QIAGEN OneStep RT-PCR kit (assay sensitivity 100 copies/mL).

Results: Five patients were HBsAg positive (3.06%) and 30 were anti HCV antibody positive by ELISA (18.40%). HCV positivity was confirmed by PCR in 17(10.42%) patients.  All patients had a minimum of two to a maximum of three dialysis sessions per week. Mean age in HBsAg positive cases was 47.3 years and all of them were male. Duration of dialysis was 8-12 years in all five HBsAg positive patients. Mean age in HCV positive patients was 42.3 years. 66% of HCV positive patients were male and 33.33% of them were female. Duration of dialysis was 0-4 years in 33.33 % of HCV positive patients, 4-8 years in 26.66% of cases, 8-12 years in 20% and 12-16 years in 20% of them.

Conclusions: This project suggests that hepatitis C infection has a high prevalence in dialysis patients and Anti-HCV Ab test should be performed before scheduling them. Although some references refuse to suggest isolation of dialysis settings for this group of patients, strategies such as closed control of services given to these patients such as blood transfusion and also training the personnel of hemodialysis units for infection prevention seems to be necessary.