Screening for hepatitis B, C and HIV infection among patients on haemodialysis (cross sectional analysis among patients from two dialysis units in the period January to July 2005).

UNLABELLED

The aim of the work was to detect the serum prevalence of HBV, HCV and HIV infections in patents with ESRD (end stage renal disease) on haemodialysis treatment from two dialysis units.

MATERIAL AND METHODS

178 patients from two haemodialysis units in Skopje (Department of Nephrology and HDC Zelezara) who received haemodialysis treatment over the period January to July 2005 were involved in a cross-sectional analysis. Patients were aged 31 to 77 (mean 54) years. Serum samples were used for: detection of markers for hepatitis B - HBs antigen (Ag), HBsT antibody (Ab) and HBcT Ab with chemiluminescent enzyme immunoassay; detection of HIV Ab and HCV Ab with the ELISA method; detection of HCV RNA with qualitative PCR. Statistical analysis was done only of patients with complete serological investigations (HCV, HBV and HIV).

RESULTS

Detectable markers for HBV infections were found in 43 patients (24.16%). Of these, 3 patients (1.68%) had positive HbsAg. Previous exposure to HBV was seen in 40 patients (22.47%). 57 patients (32.02%) had detectable markers (HCV Ab and/or HCV RNA) for HCV infections. 39 patients (21.91%) had detectable HCV RNA. 24 patients were positive for HBV and HCV markers. The total number of patients with anti HCV Ab was 56 (31.46%). All investigated patients were negative for anti HIV Ab. There is a positive correlation between AST elevation and HCV RNA (r = 0.342, p = 0.023) as well between AST elevation and HBsT (r = 0.300, p = 0.048). A positive correlation was found between ALT elevation and HCV RNA (r = 0.374, p = 0.012). A Chi square test found significance between the time on dialysis and detection of HCV RNA (chi-square 7.771, p = 0.05).

CONCLUSION

The results of our survey presented a prevalence of 24.16% of HBV and a prevalence of 32.02% of HCV in patients with renal failure on haemodyalisis programmes from two dialysis units for the six month period. HIV was not detected among the investigated patients. Immunoenzyme tests were the method of choice for the screening programme. The use of the PCR for detection of nucleic acid of viruses that can be the cause of infection for these persons is especially important. Timely detection of HBV, HCV and HIV infection among haemodyalisis patients is necessary for the due performance of therapy, as well as for taking preventive measures for the protection of other patients and staff in the haemodyalisis unit.