Prevalence and risk factors of hepatitis B and C among hemodialysis patients in Tunisia

• Published in: Médecine et maladies infectieuses 2018-05, Vol.48 (3), p.175-179
• Main Authors: Mhalla, S., Hammoud, R., Frih, A., Kadri, Y., El Argoubi, A., Elmay, M., Mastouri, M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Viral - blood; Chemiluminescence; Chronic hemodialysis; Cross-Sectional Studies; Deoxyribonucleic acid; Dialysis; DNA; DNA, Viral - blood; Female; Females; Genomes; Health risks; Hemodialysis; Hepatitis; Hepatitis B; Hepatitis B - epidemiology; Hepatitis B - prevention & control; Hepatitis B - transmission; Hepatitis B surface antigen; Hepatitis B Vaccines; Hepatitis B virus; Hepatitis C; Hepatitis C - epidemiology; Hepatitis C - prevention & control; Hepatitis C - transmission; Hepatitis C virus; Hospitals, Teaching; Humans; Hémodialysés chroniques; Immunogenicity, Vaccine; Infections; Male; Males; Middle Aged; Morbidity; Morbidity - trends; Organic chemistry; Patients; Prevalence; Real-Time Polymerase Chain Reaction; Renal Dialysis - adverse effects; Ribonucleic acid; Risk analysis; Risk Factors; RNA; RNA, Viral - blood; Tunisia; Vaccination; Virus de l’hépatite B; Virus de l’hépatite C; Viruses; Young Adult
• ISSN: 0399-077X; 1769-6690
• DOI: 10.1016/j.medmal.2017.11.006

Hemodialysis patients are at increased risk of infection by hepatitis C and B viruses, which are significant causes of mortality and morbidity. Prevention of their transmission in hemodialysis units remains a challenge worldwide. We aimed to investigate the prevalence of these two infections and to explore major risk factors among patients on chronic hemodialysis. We performed a cross-sectional study of 109 hemodialysis patients (mean duration of hemodialysis of seven years) between 2012 and 2014 in a Teaching Hospital of Monastir, Tunisia. Hepatitis B and C serological markers were searched for using a chemiluminescent assay. Genome detection was performed using a commercially available quantitative real-time PCR test. A total of 109 hemodialysis patients were enrolled (75 males and 34 females). Ages ranged from 21 to 81 years. Six (5.5%) of these 109 patients had HBV infection defined by a positive HBsAg in four (3.7%) patients and by a detectable DNA associated with an “isolated anti-HBc” profile in the remaining two patients. Hepatitis C was observed in eight patients (7.3%) and five of them had detectable RNA. Hemodialysis duration ˃5years was the main risk factor for hepatitis C infection (P=0.01; OR: 3.11; 95% CI [1.57–13.71]). Our findings confirm the downward trend of the prevalence of both hepatitis B and C infections among Tunisian hemodialysis patients. Hemodialysis duration remains the main risk factor for hepatitis C infection. Occult hepatitis B infection should be suspected and investigated, especially among patients with an “isolated anti-HBc” profile. Les hémodialysés chroniques sont à risque d’infection par les virus de l’hépatite C et B, avec une lourde mortalité et morbidité. L’objectif était d’étudier la prévalence de ces deux infections et d’explorer les principaux facteurs de risque chez les hémodialysés chroniques. Étude transversale réalisée parmi 109 hémodialysés suivis de 2012 à 2014. Les marqueurs sérologiques des virus des hépatites B et C ont été recherchés par chimioluminescence et la détection des génomes par PCR en temps réel. Au total, 109 hémodialysés chroniques ont été inclus (21 à 81 ans) avec une durée moyenne d’hémodialyse de sept ans. L’infection par le virus de l’hépatite B a été retrouvée chez six (5,5 %) patients dont quatre (3,6 %) ayant un antigène HBs positif et deux ayant un ADN détectable associé à un profil « anti-HBc isolés ». Une hépatite C était détectée chez huit patients (7,3 %) dont cinq avaient un AR