Prevalence and Risk Factors of Hepatitis B and C Virus Infections Among Patients Undergoing Hemodialysis in Kurdistan, Iraq

Abstract

Background and Objectives: Hepatitis B and C viral (HBV, HCV) infections are major the health problems worldwide. Patients undergoing hemodialysis (HD) are more vulnerable to acquire such infections than the general population. The current study aimed at assessing the prevalence and risk factors of HBV and HCV infections among patients undergoing hemodialysis in Kurdistan, Iraq. Methods: The current cross sectional study was carried out at five governmental dialysis units in Kurdistan, Iraq; most of the current study patients were recruited from 10 August 2015 to 11 February 2016. All the participants were clinically evaluated and detailed history of blood transfusion, duration of HD, and all the other parameters were also noted. Hepatitis B surface antigens (HBsAgs) and anti-HCV antibodies (anti-HCV Ab) were measured and seropositive HCV samples were subjected to polymerase chain reaction (PCR) for confirmation. Data regarding the serological status of such patients and potential risk factors were collected and analyzed. Results: A total of 510 patients undergoing HD were enrolled in the study. The overall prevalence of HBV, HCV, and coinfection in the studied subjects was 1.8%, 9.2%, and 0.2%, respectively. HBV and HCV infections were independently associated with age and history of HD (P = 0.005). HBV vaccination was a strong protective factor against HBV infection (P = 0.001), but the rate of fully vaccinated patients (77%) was still suboptimal. Other risk factors for HCV infection were the duration of HD, history of kidney transplantation, and history of dental and surgical procedures. Conclusions: The prevalence of HBV and HCV infections in the patients undergoing HD in the centers in Kurdistan was low to moderate. HBV vaccination was an efficient protective measure. The factors associated with viral hepatitis within HD units were highly suggestive for nosocomial transmission. Strict adherence to infection control measures and more effective follow-up procedures may reduce the prevalence of the studied infections.