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

OBJECTIVE

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.

DESIGN

A cross-sectional analytical study.

PLACE AND DURATION OF STUDY

Shifa International Hospital from January 2002 to June 2003. patients and

METHODS

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.

RESULTS

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).

CONCLUSION

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.