Sero-prevalence of Hepatitis B and C infection among patients with end stage renal disease at haemodialysis initiation

Abstract

Hepatitis sero-positivity at initiation of haemodialysis may suggest a causal role or arise due to repeated blood transfusions and reduced immunity associated with advanced chronic kidney disease.  This study was to determine the sero-prevalence of Hepatitis B and C infection at initiation of haemodialysis, and describe the clinical characteristics and outcome of patients.  This is a cross-sectional study of all end stage renal disease (ESRD) patients who had haemodialysis from January 2012 to January 2016 in the study centre. Patients with HIV infection were excluded. Data on the demographic characteristics, health status, aetiology of renal disease, clinical and biochemical parameters were collected. Fifteen (4.9%) out of 341 patients were hepatitis sero-positive; 2.6% were hepatitis B seropositive, while 2.3% were hepatitis C positive. Majority (86.6%) of the patients were males. Hepatitis infection was significantly commoner among patients with sickle cell disease (2 out of 6, p=0.005). Median duration on haemodialysis was 1 month (IQR 0.6, 1.0), while mortality was 20%. Hepatitis B and C infection is commoner among male ESRD patients, the young/middle-aged, and patients with sickle cell disease. Majority of patients are unaware of their hepatitis status and are treatment naive. Haemodialysis treatment drop-out rate and mortality are high. Key words: Hepatitis, end stage renal disease, haemodialysis, sickle cell disease.