Epidemiology of Hepatitis B & C virus infections among hemodialysis patients: A cross-sectional survey in five hemodialysis centers in Yemen
Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections represent significant public health issues globally. They are important causes of morbidity and mortality in hemodialysis patients. Patients with HBV/HCV co-infection have a higher risk of progression to cirrhosis and decompensated liver disease and have an increased risk of hepatocellular cancer (HCC). Aim: to assess epidemiology of hepatitis B and C virus infections in patients undergoing hemodialysis in five hemodialysis centers in Yemen. Methods: A cross-sectional survey was applied; a five hemodialysis centers study was carried out in Yemen. All the patients who underwent hemodialysis from January 2019 to December 2019 were included in the study. Patients of all age groups were tested for anti-HCV antibodies by a third generation enzyme linked immunoassay (ELISA). ELISA tests were performed in local laboratories. These tests obtained annually or every six months, different from center to other and between the patients. Results: Of the total 521 patients on hemodialysis, 34 (6.53%) were found to be having HBsAg infection, 54 (10.36%) were found to be positive for HCV. Co-infection with HBV/HCV was observed in 3 (0.58%) patients, 351 (67.4%) were males and 170 (33%) were females. The majority of the patients were found to be of 41-65 years of age (46.0%), followed by 18-40 years (32.0%) and thereafter in ≥ 65 years (22.0%) and lowest prevalence was observed in the age group of <18 years (1.34%). Percentage of hepatitis in various hemodialysis center was higher in males compared to females and was statistically significant (P = 0.028). Duration since initiation of dialysis was associated with hepatitis in various hemodialysis center (P = 0.0006). Conclusion: Patients on maintenance hemodialysis in five centers, included in our study, have a high prevalence of HCV infection more than rates of HBV infection. The factors associated with HBV and HCV infection are highly suggestive of nosocomial transmission within HD units. Urgent action is required to improve infection control measures in hemodialysis centers and to reduce dependence on blood transfusions for the treatment of anemia associated with End-Stage Renal Disease (ESRD). We need to increase the capacity of each center and isolate HBV & HCV seropositive patients.