P1122VIRAL INFECTIONS :VHC, VHB AND VIH IN HEMODIALYSIS

Abstract

Abstract Background and Aims Viral infections, especially those caused by hepatitis B and C viruses are common in chronic hemodialysis patients. The hepatitis C virus is the main cause of post-transfusion hepatitis. The main objective of this study is to determine the prevalence of hepatitis B and C and HIV in chronic hemodialysis patients at the TIZI OUZOU University Hospital Center, as well as the main risk factors for contamination, in chronic hemodialysis patients treated at the from our center. Method This retrospective study carried out on 149 chronic hemodialysis patients consisted in searching for anti-HCV, anti-HIV antibodies and the HBs antigen and in determining the possible causes of contamination, in particular the age of the hemodialysis and history of blood transfusion. The characteristics studied for all patients are: demographic characteristics, initial nephropathy, seniority on hemodialysis, the concept of hemodialysis outside our center at the time of dialysis or for a limited period during follow-up ( vacation…), the notion of transfusion; patients are considered to be multi-transfused when they have received more than four transfusions, the search for hepatitis B and C virus infection by ELISA, the concept of hepatic cytolysis: a transaminase level that exceeds 1.5 times normal, vaccine status, HIV serology Results The average age of our 149 patients varies between 19 and 82 years with a male predominance (92 men and 57 women) and an average duration of dialysis of 90 months. The predominant etiology of IRCT is vascular nephropathy. We also note other causes including glomerular, diabetic and tubulointerstitial nephropathies. The etiology was largely undetermined. Hepatic serology C is positive in 5% of patients. None of our patients tested positive for HBS. No case of HIV infection has been noted. The prevalence of hepatitis B and C in hemodialysis patients varies from country to country but remains higher than in the general population (HCV: 2.7-22.2% in the DOPPS register). In our series the prevalence is around 5% lower than that reported in other regional and international studies. Conclusion In hemodialysis, the risk of infection is very high, on the one hand due to access to regular blood and on the other hand due to the alteration of the immune defenses induced by chronic renal failure. Nosocomial transmission plays a very important role. It is strongly linked to the age of dialysis. Compliance with hygiene measures is a very essential element; isolation of the infected patient is no longer recommended