Mufti Baleegh-ur Rehmeem Mahmood, Ahmad Zeb Khan, Zahidullah Khan, Tariq Ikram, Muhammad Kashif, Shahid Zia.
Risk factors for transmission of viral hepatitis b and c in hemodialysis patients.
J Saidu Med Col Jan ;7(1):26-30.

BACKGROUND: Viral hepatitis has high prevalence among hemodialysis dependent patients. We aimed to study the common risk factors for viral hepatitis in hemodialysis dependent patients. OBJECTIVE: The objective of this study was to determine the frequency of common risk factors for transmission of viral hepatitis B and C in patients on maintenance hemodialysis. MATERIAL & METHODS: It was a descriptive cross-sectional study of the hemodialysis patients at the Institute of Kidney Diseases and Khyber Teaching Hospital Peshawar, Pakistan, conducted from December 2015 to February 2016. Fifty HBV or HCV positive hemodialysis dependent patients were selected randomly and were asked to fill a questionnaire asking about the risk factors for acquisition of viral hepatitis. RESULTS: Of the 50 HBV & HCV positive patients, 38 patients were positive for anti-HCV Antibody (M: F=1:1.2), 08 patients were HBsAg positive (M: F=1.6:1) and 04 patients were positive for both anti-HCV Ab and HBsAg (M: F = 3:1). Their mean age was 43.8 years (SD ±16.16, Range 18-80 years). Around 42 (84.0%) patients had acquired viral hepatitis after initiation of hemodialysis therapy. Around 47.6% of these patients were found to be positive within 06 months of initiation of dialysis and a total of 69.0% patients had acquired the viral infection within the first year after initiation of dialysis. The mean duration of dialysis at the time of diagnosis of viral infection was 10.4 months (SD ±12.1, Range 1-50). Around 35 (70%) patients reported a history of transfusion of blood or blood products, 19 (38%) of these patients reported dialysis at multiple centers, 10 (20%) patients reported positive history of surgical procedures. Only 01 (2%) patient reported needle sharing and 04 (8%) patients had an infected close relative. Only Ten (20%) patients were vaccinated against hepatitis B. Only 07 (14%) patients had received antiviral therapy in the past. CONCLUSION: A great majority of our patients acquired infection after starting hemodialysis and most of the patients became infected within the first year after starting dialysis. Blood product transfusion was the commonest risk factor for the transmission of viral hepatitis followed by multicenter dialysis. Very few patients were ever vaccinated against HBV. The patients were not commonly offered antiviral therapy for treatment of viral hepatitis. Key Words: Hemodialysis, End Stage Renal Disease, Chronic Kidney Disease, Viral hepatitis, Hepatitis B, Hepatitis C.

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