Hepatitis C Infection and Related Factors in Hemodialysis Patients in China: Systematic Review and Meta-Analysis

Abstract

Background and Aims. To provide a comprehensive and reliable tabulation of available data on the epidemiological characteristics and risk factors for hepatitis C virus (HCV) infection in maintenance hemodialysis (HD) patients in China, and to help inform prevention programs and guide future research. Methods. A systematic review was constructed based on the computerized literature database by two reviewers independently. Ninety-five percent confidence intervals (CI) of infection rates were calculated using the approximate normal distribution model. Odds ratios and 95% CI were calculated by fixed or random effects models. Results. Forty-three studies met our inclusion criteria. The pooled prevalence of HCV infection among HD patients in China was 41.1% (95% CI 39.5–42.6%). No significant difference was found in HCV infection rates between male and female HD patients (OR = 0.75, 95% CI 0.52–1.07, p = 0.11). HD patients with blood transfusion were 5.65 times more likely to be infected with HCV than HD patients without blood transfusion. A longer duration of HD was associated with increased HCV prevalence. Co-infection with hepatitis B virus did not increase the probability of HCV infection among HD patients (OR = 1.19, 95% CI 0.34–3.20, p = 0.73). Conclusions. Viral hepatitis is still one of the main complications in HD patients, with hepatitis C being the most common one. The key to reducing the incidence of viral hepatitis in HD patients is to control contagion and reduce the frequency of blood transfusion and cross-infection.