Prevalence of hepatitis C, hepatitis B, and HIV infection among hemodialysis patients in Jenin District (Palestine)

Abstract

Background and Aims: End-stage renal disease patients treated by hemodialysis (HD) are more susceptible for infection by viral hepatitis and human immunodeficiency virus (HIV) infections. Infection by these viruses is promoted by the characteristic immunological dysfunction that develops in renal failure and interferes with the patient's ability to eliminate these viruses. Prevalence of these viruses among hemodialysis patients in Jenin District (Palestine) was not studied until now, we aimed in this study to determine the prevalence of HCV, HBV and HIV among hemodialysis patients in Jenin District using serological methods, and to define the main risk factors for HCV infection. Materials and Methods: End-stage renal disease (ESRD) patients on maintenance hemodialysis from various demographic areas in Jenin District were included in the study. Data such as age, sex, drug abuse, history of transplantation were examined. Serological markers for HCV, HBV and HIV were determined using a microparticle enzyme immunoassay (MEIA). Pearson’ s correlation factor and independent samples t-test were used to analyze the significance of results. Results: The patients were 77 (42 males, 35 females, mean age 50.73 ± 16.78 years [age range: 14 – 80 years]), the mean duration of dialysis was 26.97 months with a standard deviation of 35.19 days. The prevalence of HCV was 24.68 % while the prevalence of HBsAg and HIV were 0% respectively. HCV seropositivity was associated with longer period of dialysis (P=0.000). There was no statistically significant correlation between age and HCV seropositivity (P=0.630), also there was no statistically significant relationship between sex and infection with HCV (P=0.849). Conclusion: The prevalence of HCV among hemodialysis patients in Jenin District is high compared to many Arab and other countries. None of the patients were a former drug abuser or had a history of tattooing. None of the patients was with a former transplant was HCV positive, so it seemed that the infection was mainly nosocomial during dialysis process. Duration of dialysis was an important risk factor (P=0.000). Dialysis staff, incomplete disinfection of dialysis machines (monitors), non-isolation of HCV positive patients on special dialysis units or special monitors may be important risk factors. So, careful attention of the preventive infection control measures is essential to limit the transmission of HCV in the dialysis unit in Jenin District.