The Vulnerability of Middle-Aged and Elderly Patients to Hepatitis C Virus Infection in a High-Prevalence Hospital-Based Hemodialysis Setting

• Published in: Journal of the American Geriatrics Society (JAGS) 2004-02, Vol.52 (2), p.242-246
• Main Authors: Saxena, Anil K., Panhotra, Bodh R.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age differences; Age Distribution; Age Factors; Aged; Aged, 80 and over; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Cross Infection - epidemiology; Cross Infection - transmission; Cross Infection - virology; Dialysis; Disease Susceptibility; elderly; Elderly people; End state; Female; HCV transmission; Hemodialysis; Hepatitis; Hepatitis C; Hepatitis C - epidemiology; Hepatitis C - transmission; Hepatitis C virus; Hospitals; Human viral diseases; Humans; Infection; Infectious diseases; Kidney diseases; Kidney Failure, Chronic - etiology; Kidney Failure, Chronic - virology; Male; Medical sciences; Middle age; Middle Aged; Middle aged people; Older people; Patients; Pharmacology. Drug treatments; Renal Dialysis - adverse effects; Retrospective Studies; Risk Factors; Saudi Arabia; Saudi Arabia - epidemiology; seroconversion; Seroepidemiologic Studies; seroprevalence; Sex Distribution; Susceptibility; Viral diseases; Viral hepatitis
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2004.52062.x

Objectives: To determine the relationship between advancing age and the risk of acquiring hepatitis C virus (HCV) infection, through evaluation and statistical comparison of seroprevalence and seroconversion rates in different age groups of patients on long‐term hemodialysis (HD). Design: Retrospective cohort study. Setting: Hemodialysis facility of King Fahad Hospital and Tertiary Care Center, Al‐Hasa region of the eastern province of Saudi Arabia. Participants: One hundred ninety‐eight patients with end‐stage renal disease enrolled for long‐term HD therapy from September 1995 to September 2000. Measurements: HCV seroprevalence and seroconversion rates. Results: The overall HCV seroprevalence of 43.4% (86/198) and seroconversion rate of 8.6% per year were recorded. Patients aged 55 to 64 had the highest anti‐HCV prevalence (55.3% (26/47)) and annual seroconversion rates (11.0%). Those aged 65 to 74 had the next‐highest prevalence (48.9% (24/49)) and seroconversion rate (9.7%), and patients aged 15 to 24 had the lowest prevalence (12.5% (1/8)) and seroconversion rate (2.5%) (reference group). Conclusion: Significantly higher annual seroconversion rates in those aged 55 to 64 and 65 to 74 during a shorter dialysis period (35.6 and 32.7 vs 58.0 months), suggest the greater susceptibility of the middle‐aged and elderly patients to acquisition of HCV infection than the younger (15–24 years) group. This could be attributed to the combined effect of immunosuppression associated with advancing age, uremia, and undernutrition, but multicenter molecular follow‐up studies with larger sample sizes would be needed to corroborate these findings and plan appropriate strategies for these high‐risk groups.