Hepatitis B and C in hemodialysis patients

The prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and their associations in 405 hemodialysis (HD) patients (209 males and 196 females) was evaluated in this study. A comparison was also made with 526 normal patients (266 males and 260 females). Screening for hepatitis B antibody was carried out with the radioimmunoassay (RIA) method, and for anti-HCV with the enzyme immunoassay (EIA) method. Three hundred and third- two HD patients (82.0%) were anti-HBc positive, with no significant difference from the control group (81.9%). One hundred and forty-five HD patients (35.8%) were anti-HCV positive, a much greater prevalence than the control group (4.9%). The high prevalence of HBV in these HD patients probably reflects acquisition of HBV infection before entry onto chronic dialytic therapy in a region of the world that is hyper-endemic for HBV. On the contrary, the prevalence of seropositivity to anti-HCV correlated with the number of transfusions, the length of time on HD, and a higher rate of dialyzer reuse. Similar correlations occurred in those HD patients with seropositivity to both anti-HBc and anti-HCV. A higher prevalence rate of HCF infection in our study was observed when compared with other countries (35.8% vs. 7-23%), even though our patients had a relatively shorter mean duration of HD (40 months vs. 57-66 months). We conclude that blood transfusions, dialyzer reuse, and patient-to-patient contamination during HD play a role in the higher prevalence rate of HCV infection, as well as in combined HBV and HCV infections, in HD patients.