Risk factors for hepatitis C virus infection in patients on long-trem hemodialysis

ABSTRACT

To estimate the frequency of hepatitis C virus [HCV] infection in patients on hemodialysis at Shifa International Hospital and determine the association of various risk factors in the acquisition of hepatitis C infection. A cross-sectional analytical study. Shifa International Hospital from January 2002 to June 2003. All patients on long-term hemodialysis in Nephrology Unit of Shifa International Hospital were studied. Their medical records were reviewed for the presence of anti-HCV in all patients. Any risk factors were noted from the patient's records and from the history of those patients who were regularly attending the dialysis unit. A total of 97 patients on hemodialysis were included. Out of these, 23 [23.7%] were found to be anti-HCV positive. The mean age of HCV positive patients was 55.2 +/- 15.5 years while for the anti-HCV negative patients it was 54.9 +/- 15.1 years. There were 18 [78.3%] males in the HCV positive group while 46 [62.2%] males in the HCV negative group. The mean duration of dialysis among HCV positive patients was 2.9 +/- 2.7 years while the mean duration of dialysis in HCV negative patients was 1.51 +/- 0.86 years [p-value 0.000]. Anti-HCV positive group had significantly greater proportion of patients with a history of dialysis more than 2 years [43.5% vs 9.5%], adjusted odds ratio being 0.45 [95% CI 0.27-0.75]. No significant difference in other risk factors between the two groups was found. When years of dialysis were treated as categorical variable, significant difference between the anti-HCV positive and negative groups was found. The risk of getting HCV was found to be significantly associated with increasing years of dialysis, [adjusted p-value 0.002]. Patients on hemodialysis in our unit had 23.7% positivity of anti-HCV and history of dialysis over more than 2 years was noted to be a significant risk factor for acquisition of infection in these patients