Prevalence of hepatitis C in patients with chronic kidney disease at a tertiary care hospital in north India: a retrospective analysis

ABSTRACT

Background: Hepatitis C and chronic kidney disease (CKD) both present an unsolved public health problem Hepatitis C virus (HCV) is easily transmitted in haemodialysis units and by kidney transplantation. HCV leads to increased mortality and morbidity due to cirrhosis and hepatocellular carcinoma, while accelerating the progression of CKD. The aim of the  study was to describe the demographic, clinical/biochemical profile and prevalence of patients with CKD who have HCV infection.Methods: This was a retrospective analysis of patients with CKD who presented to out/in patient department of medicine in a tertiary care center in Jammu from a period of Feb 2016 to Nov 2018. Detailed clinical history along with previous lab reports were noted and tests for HCV infection were conducted in all patients. Diagnosis of HCV was made via HCV RNA(RT PCR) and positive  Anti HCV IgG serology.Results: Total 67 patients were included with median age of 54 years (range 43-72 years) with majority 76.1% being males, and 71.6% within 41-60 years age group. 31.4% were HCV positive out of which 81% were males. 7 patients were found to have co-infection with HIV and HBsAg. Genotype 1 (72%) was found to be more common than Genotype 3. Ultrasonography and Upper GI endoscopy showcased 57% with dilated spleenoportal axis  and oesophageal varices respectively.Conclusions: Prevalence of HCV infection in CKD patients is high with genotype 1 being commonest. False negative Anti HCV antibody is common hence screening with HCV RNA is recommended. Strict universal precautions should be employed in hospitals and dialysis units to prevent transmission.