Seroprevalence and risk factors for Hepatitis C virus among maintenance hemodialysis patients at a Tertiary Care Hospital in Puducherry, India

Abstract

Background: Hepatitis C virus (HCV) infection is a serious public health problem and the most significant cause of liver disease in patient receiving dialysis for a long term. The prevalence of HCV infections among dialysis patients varies markedly from country to country. Tight infection control measures implemented in developed countries have minimized the transmission rate, while the prevalence still remains high in the developing world. The aim of this study is to estimate the prevalence rate of HCV infection in hemodialysis patients, to describe demographic characteristics of individuals infected with HCV and to determine whether HCV-polymerase chain reaction (PCR) testing identifies HCV infections not detected by anti-HCV testing. Methods: This retrospective record-based study was carried in Aarupadai Veedu Medical College and Hospital, a Tertiary Care Center in Puducherry, A total of 258 chronic renal failure patients on hemodialysis were studied and tested for anti-HCV antibodies by 4th generation HCV TRIDOT ELISA and real time-PCR. Results: Anti-HCV antibodies were positive in 34 (13.2%) patients, comprising 27 (79.4%) males and 7 (20.6%) females. The majority of patients were found to be positive; between 41 and 60 age 24 (70.5%). HCV RNA was detected in 38 (14.72%) patients. The mean age of patients undergoing dialysis was 45 years. 12 (35%) had raised aspartate transaminase (AST) levels and 14 (41%) had raised alanine transaminase (ALT) levels. Gamma-glutamyl transferase was found to be raised in 25 (73.5%) of the subjects. All the 34 HCV seropositive patients were hypertensive and 33% had diabetes mellitus. 23 (67.6%) patients had undergone dialysis in more than one center. Conclusions: Regular screening of patients for HCV is absolute necessity for early detection of HCV infection that could result in better management of patients and also stresses on the importance of HCV RNA detection by PCR. Strict adherence to universal precautions, the use of dedicated machines along with regular surveillance for HCV in HD units will dramatically decrease the risk of transmission of HCV.