Factors Correlating to the Development of Hepatitis C Virus Infection in Hemodialysis Patients-Findings Mainly from Asiatic Populations: A Systematic Review and Meta-Analysis.

Gaofeng Cai,Lan Luo,Yongdi Chen,Biao Zhou,Zhengting Wang,Chonggao Hu,Shuangfei Xu,Huakun Lv,Hongjie Zheng,Zhenggang Jiang

doi:10.3390/ijerph16081453

Abstract

Hemodialysis is an effective replacement therapy for chronic renal failure patients. In recent decades, the number of hemodialysis patients has grown rapidly and some measures for preventing blood-borne diseases have been implemented, but hepatitis C virus (HCV) infection remains a significant problem. The meta-analysis published in 2009 on HCV infection-related factors was based on localized study objects, and some additional studies have been published since 2009; however, the contribution of these factors remains under dispute. Our study pooled the odds ratios (ORs) or mean standard deviations (MDs) with 95% confidence intervals (CIs) and analyzed sensitivity using Review Manager 5.1 software (5.1 version Copenhagen: The Nordic Cochrane Centre; 2011) by searching data in the PubMed, Elsevier, Springer, Wiley, and EBSCO databases. Spearman correlation analysis was performed using the SPSS package. In our meta-analysis, 1715 HCV-infected hemodialysis patients and 7093 non-HCV-infected hemodialysis patients from 44 studies were analyzed. The pooled ORs with 95% CIs were: histories of blood transfusion, 4.30 (3.11, 5.96); weekly hemodialysis times > 2, 6.00 (3.25, 11.06); kidney transplantation, 5.80 (3.95, 8.52); hemodialysis units > 2, 6.90 (2.42, 19.68); shared hemodialysis devices, 5.00 (2.35, 10.65); and drug addiction, 4.73 (1.54, 14.47). The pooled MDs with 95% CIs were duration of hemodialysis (months) 27.48 (21.67, 33.30). There was a positive correlation between duration of hemodialysis and the HCV infection rate (p < 0.01). Hemodialysis patients, especially from Asia, with shared hemodialysis devices, hemodialysis units > 2, blood transfusion, kidney transplantation, and drug addiction were at increased risk of HCV infection. The HCV infection rate increased with the duration of hemodialysis. High-risk hemodialysis patients should be monitored and receive timely screening.

Highlights

MethodsSearches were performed for each of the specified databases on the Bo Ku data service platform
Hemodialysis is an effective replacement therapy for chronic renal failure patients that can increase survival times [1]
This meta-analysis found that hemodialysis patients with a duration of hemodialysis treatment >5 years and/or histories of blood transfusion and/or shared hemodialysis devices and/or hemodialysis units >2 and/or weekly hemodialysis times >2 and/or kidney transplantation and/or histories of surgery and/or drug addiction were at increased risk of developing hepatitis C virus (HCV) infection, whereas the age and gender of hemodialysis patients did not affect the risk of developing HCV infection

Summary

Methods

Searches were performed for each of the specified databases on the Bo Ku data service platform. We used the search terms “Hepatitis C”, “HCV”, and “Hemodialysis” in the search field “Title/Abstract”, and the electronic databases searched included the following six international databases: PubMed, Elsevier, Springer, Wiley, OVID, and EBSCO. We used the search terms “Hepatitis C”, “HCV”, and “Hemodialysis” in the search field “Abstract” and searched two Chinese electronic databases: Chinese Medical Journal Database and Chinese National Knowledge Infrastructure. The searches were completed in the first week of September, 2018. We searched the references listed at the end of the included articles

Results

Discussion

Conclusion