Investigation of the change in seroprevalence of viral hepatitis in patients receiving hemodialysis treatment over the years: A Single-Center Study

Year 2023, , 507 - 514, 30.11.2023

Safiye Koçulu Demir , Tülin Akagün

https://doi.org/10.46871/eams.1229510

Abstract

Objective: In this study, it was aimed to evaluate HBV, HCV, and HIV seroprevalence and their 9-year changes in patients receiving hemodialysis (HD) treatment in the Giresun province in Turkey.
Material-Methods: A total of 607 patients over the age of 18 who received hemodialysis treatment in Giresun – Turkey, provincial and district hospitals in 2013 and 2022 were included in our study. The files of the patients were reviewed retrospectively. Demographic characteristics of the patients and serology results of HBV, HCV, HDV, and HIV were recorded. The data was evaluated using the IBM SPSS Statistics 25.0 program.
Results: A total of 607 patients, 385 of whom received HD treatment in 2013 and 222 who received HD treatment in 2022, were included in the study. 230 (59.7%) in 2013 and 135 (60.8%) in 2022 of male patients. While the mean age of the patients was 60.26±14 years in 2013, it was 63.08±13.18 years in 2022. In 2013, HBsAg positivity was detected in 9 (2.3%), HBV-DNA positivity in 4 (44.4%), anti-HCV positivity in 31 (8.1%), and HCV-RNA positivity in 8 (25.8%) patients. In 2022, HBsAg positivity was detected in 4 (1.8%), HBV DNA positivity in 2 (50%), and anti-HCV positivity in 31 (8.1%) patients. Compared with dialysis duration, the anti-HCV positivity rate was significantly increased in patients with long dialysis duration (p<0.001).
Conclusion: In line with the health policies, the epidemiological data obtained support a decrease in the population’s seroprevalence of HBV and HCV. However, according to the results of our study, it was determined that there was no significant decrease in HBsAg seroprevalence in patients who received HD treatment over nine years.
As a result, it was concluded that it would be beneficial to closely monitor the seroprevalence of viral hepatitis in patients receiving HD treatment.

Keywords

Hemodialysis, HBV, HCV, HIV, seroprevalence

References

• 1. Thurlow JS, Joshi M, Yan G, et al. Global epidemiology of end-stage kidney disease and disparities in kidney replacement therapy. Am J Nephrol. 2021; 52(2):98–107.
• 2. Recommendations for preventing transmission of infections among chronic hemodialysis patients. MMWR Morb Mortal Wkly Rep. 2001; 50(RR-5): 1-43.
• 3. Akarca US, Baykam N, Güner R, et al. Eliminating Viral Hepatitis in Turkey: Achievements and Challenges. Viral Hepat J 2022;28:47-54.
• 4. World Health Organization. Global Health Sector Strategy on Viral Hepatitis 2016-2021 [Internet]. (cited 2022 Jul 30). Available from: https://apps.who.int/iris/bitstream/handle/10665/246177/WHO-HIV2016.06-eng.pdf.
• 5. Tozun N, Ozdogan O, Cakaloglu Y, et al. Seroprevalence of hepatitis B and C virus infections and risk factors in Turkey: a fieldwork TURHEP study. Clin Microbiol Infect. 2015;21:1020-1026.
• 6. Polaris Observatory HCV Collaborators. Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: a modelling study. Lancet Gastroenterol Hepatol. 2022;7:396-415.
• 7. Finelli L, Miller JT, Tokars JI, et al. National surveillance of dialysis-associated diseases in the United States, 2002. Semin Dial. 2005; 18:52.
• 8. Johnson DW, Dent H, Yao Q et al. Frequencies of hepatitis B and C infections in hemodialysis and peritoneal dialysis patients in Asia-Pacific countries: analysis of registry data. Nefrol Dial Transplant 2009; 24:1598.
• 9. Guimarães MNC, Facincani T, Santos SSD. Hepatitis B status in hemodialysis patients. ArqGastroenterol 2017; 54: 356-8.
• 10. García Agudo R, Aoufi Rabih S, Barril Cuadrado G, et al. Spanish multicentre PIBHE study: prevalence and immunization of chronic hepatitis B in hemodialysis patients in Spain. Nephrology 2016; 36: 126-32.
• 11. Lodhi A, Sajjad A, Mehmood K, et al. Profile and predictors of hepatitis and HIV infection in patients on hemodialysis of Quetta, Pakistan. Drug Discoveries & Therapeutics 2019; 13: 274-9.
• 12. MR Ibrahim N, Sidiq Mohammed Saleem Z, R Hussein N. The Prevalence of HIV, HCV, and HBV among hemodialysis patients attending Duhok Hemodialysis Center. Int J Infect 2018; 5: e63246.
• 13. Hasanjani Roushan MR, Farokhtabar S, Bayani M, Siadati S. Epidemiological aspects of hepatitis B and C and human immunodeficiency viruses among hemodialysis patients in Mazandaran province, Iran. Nephrourol Mon 2016; 8: e37878.
• 14. Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet 2015; 386: 1546-55.
• 15. Kaygusuz Ö. Prevention of HBsAg and AntiHbs in chronic hemodialysis patients. F.U. Sağ. Know. Derg. 2007; 21: 55-57.
• 16. Sırmatel F, Sırmatel Ö, Usalan C, Barlıoğlu C, Göymen A, Kepekçi E, et al. Seroprevalence of viral Hepatitis B and C in hemodialysis patients. Turkish Journal of Infection. 2008; 22: 23-8.
• 17. Evirgen Ö, Önlen Y, Köksaldı Motor V, Mahsereci E, İnci M, Şahin Ş. Evaluation of antibody response caused by HBV, HCV seroprevalence, and hepatitis B vaccination in hemodialysis patients in Hatay. Viral Hepatitis J 2010; 16: 57-63.
• 18. Cicek AC, Sahin OZ, Topaloglu MK, Kazanci AAT, Invincible IH, Sahin K, Gundogdu DZU. The Seroprevalence of HBsAg, Anti-HBs and Anti-HCV in Patients Applied Hemodialysis in Rize Province. Viral Hepatitis J. 2013;19(1); 15-18.
• 19. Karlıdag EG, Küçüksu M, Demir M. HBsAg, Anti-HBs, Anti-HCV and HIV seroprevalence in Hemodialysis Patients in Elazig Province. Viral Hepatitis J 2018;24(2):53-56. 10.4274/vhd.2018.0004.
• 20. Temiz H, Kaya Ş, Berekatoğlu N, Temiz S, Danış R. Evaluation of antibody response caused by HBV, HCV and HIV seroprevalence and hepatitis B vaccination in hemodialysis patients. Viral Hepat J 2013; 19: 140-3.
• 21. Yüksel E, Kaya Ş, Günay E, Araç E. Seroprevalence of HBV, HCV and HIV in hemodialysis patients. Klimik Journal. 2019; 32(2): 165-167.
• 22. Sayar MS, Bulut D, Haykir Solay A. Serologic indicators of HBV, HCV, and HIV in hemodialysis patients in Van Training and research hospital. Ankara Training and Research Hospital Medical Derg 2019; 52: 153-157.
• 23. Furuncuoğlu Y, Sağlam F, Bölükbaş FF, Bölükbaş C, Öztürk R. Seroepidemiology of Hepatitis B Virus Infection in Istanbul: A 20-year Survey. Viral Hepat J. 2016;22:88-91.
• 24. Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology of hepatitis C virus infection and genotype distribution. J Hepatol. 2014; 61(1 Suppl):S45-57.
• 25. Greeviroj P, Lertussavavivat T, Thongsricome T, et al. The world prevalence, associated risk factors and mortality of hepatitis C virus infection in hemodialysis patients: a meta-analysis. J Nephrol. 2022; 35:2269–82.
• 26. Dağlar D, Ergani A, Demirbakan H, Ozhak Baysan B, Ongüt G, Koçak H, Oğünç D, Akbaş H, Yıldırım B, Colak D. Investigation of hepatitis B and hepatitis C virus infections by serological and molecular methods in hemodialysis patients. Microbiol This. 2014 Jan;48(1):143-50.
• 27. Ergen P, Aydın Ö, Erbakan AN, Alışır Ejder S. Overview of blood-borne viral infections in hemodialysis patients: hepatitis B, hepatitis C, human immunodeficiency virus infections. Journal of Health Sciences and Medicine. 2022; 5(1): 195-200 . DOI: 10.32322/jhsm.991215.
• 28. Turkey 2019 Year National Nephrology, Dialysis, and Transplantation Registration System Report. Nephrology, Dialysis, and Transplantation in Turkey. Republic of Turkey Ministry of Health and Turkish Nephrology. Association Joint Report http://www.nefroloji.org.tr/folders/file/registry_2019.pdfISBN 978 - 605 - 62465 - 0 – 0 Ankara – 2020, Accessed 6 december 2022.
• 29. Chou CC, Sun CY, Wu MS. Human immunodeficiency virus (HIV) infection screening in a dialysis unit. Ren Fail 2007; 29:459.
• 30. HIV-AIDS Statistics, Republic of Turkey Ministry of Health, General Directorate of Public Health, Department of Infectious Diseases and Early Warning. https://hsgm.saglik.gov.tr/tr/bulasici-hastaliklar/hiv-aids/hivaids-liste/hiv-aids-istatislik.html, Accessed 6 december 2022.
• 31. Turkey 2015 National Nephrology, Dialysis, and Transplantation Registration System Report. Nephrology, Dialysis, and Transplantation in Turkey. T.R. Ministry of Health and Turkish Society of Nephrology Joint Report https://www.nefroloji.org.tr/folders/file/2015_ REGISTRY_kontrol_v2.pdf, Accessed 31 August 2021.
• 32. Stevens CE, Alter HJ, Taylor PE, et al. Hepatitis B vaccine in patients receiving hemodialysis. Immunogenicity and efficacy. N Eng J Med 1984; 311:496.
• 33. Buti M, Viladomiu L, Jardi R, et al. Long-term immunogenicity and efficacy of hepatitis B vaccine in hemodialysis patients. J Nephrol 1992; 12:144 p.m.
• 34. Oesterreicher C, Hammer J, Koch U, et al. HBV and HCV genome in peripheral blood mononuclear blood cells in patients undergoing chronic hemodialysis. Kidney Int 1995; 48(6): 1967–71.
• 35. Çalışkan Sarı A, Ok G, Aksanyar Y, Kadıoğlu AK, Uylaş T. Development and Evaluation The Effectiveness of Social Cohesion and Life Education Program That Applied To Foreigners Living in Turkey. The Journal of Migration Stu. 2021;7:188-209.
• 36. Hıdıroğlu S, Karavuş M, Topuzoğlu A, Şalva T. Hepatitis B, knowledge, attitude and behavior of coiffures. TAF Preventive Medicine Bulletin. 2006:5:276-286)