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Abstract
Background
Compared to the general population, Hemodialysis (HD) patients have been shown to be at higher risk of blood borne viral infection among which Hepatitis B virus (HBV) and Human immune deficiency virus (HIV).
With increasing access to HD in Cameroon, we opted to assess the prevalence of these viral infections among chronic HD patients of Douala General Hospital dialysis center.
Methods
From October to December 2012, all consenting patients of this center were screened for hepatitis B surface antigen (HBsAg) and anti-HIV antibodies. HBsAg was determined using a commercial third generation assay (BIOREX®). Anti HIV was first determined using a rapid HIV 1 and 2 Ag/Ab Combo test and confirmed using ImmunoComb® II HIV 1 & 2 BiSpot.
Results
A total of 166 patients were studied 63.9% of whom were men. Mean age was 49.2 ± 14.2 years and median duration in dialysis was 24months [(Interquartile range (QR):8 – 42]. Hypertension was the main aetiology of end stage renal disease (ESRD) in 25.9% of patients. In the study population, 18.7% of patients had markers of at least one viral infection; HBsAg 7.8% and HIV 10.8% with only one patient (0.6%) being co-infected. Longer duration in dialysis was associated with lower prevalence of both infections, odd ratio (OR) 0.2 (95%CI 0.03 – 0.8, p<0.01) for HBsAg and 0.3 (95%CI 0.1 – 1.0, p<0.05) for HIV. No association was found with a history of STI, scarification and previous transfusions.
Conclusion
HBV and HIV infections are common among dialysis patients in Douala thereby warranting strict adherence to infection control measures.
Key words: Hepatitis B, HIV, end stage renal disease, hemodialysis
Article Details
References
- Wreghitt TG, Blood-borne virus infections in dialysis units--a review. Reviews in medical virology, 1999; 9(2): p. 101-9.
- 2. Fabrizi F, Martin P, and Messa P, Hepatitis B and hepatitis C virus and chronic kidney disease. Acta gastro-enterologica Belgica, 2010; 73(4): p. 465-71.
- 3. Fabrizi F, Lunghi G, and Martin P, Hepatitis B virus infection in hemodialysis: recent discoveries. Journal of nephrology, 2002; 15(5): p. 463-8.
- 4. Fabrizi F, Poordad FF, and Martin P, Hepatitis C infection and the patient with end-stage renal disease. Hepatology, 2002; 36(1): p. 3-10.
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- 14. Zahedi MJ, Darvish Moghaddam S, Alavian SM, and Dalili M, Seroprevalence of Hepatitis Viruses B, C, D and HIV Infection Among Hemodialysis Patients in Kerman Province, South-East Iran. Hepatitis monthly, 2012; 12(5): p. 339-43.
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- 17. Alashek WA, McIntyre CW, and Taal MW, Hepatitis B and C infection in haemodialysis patients in Libya: prevalence, incidence and risk factors. BMC infectious diseases, 2012; 12: p. 265.
- 18. Khosravani A, Sarkari B, Negahban H, Sharifi A, Toori MA, and Eilami O, Hepatitis B Infection among high risk population: a seroepidemiological survey in Southwest of Iran. BMC infectious diseases, 2012; 12: p. 378.
- 19. UNICEF, Cameroon statistic. Available on http://www.unicef.org/infobycountry/cameroon_statistics.html. Accessed on 27/08/2012, 2010.
- 20. Boulaajaj K, Elomari Y, Elmaliki B, Madkouri B, Zaid D, and Benchemsi N, [Prevalence of hepatitis C, hepatitis B and HIV infection among haemodialysis patients in Ibn-Rochd university hospital, Casablanca]. Nephrol Ther, 2005; 1(5): p. 274-84.
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References
Wreghitt TG, Blood-borne virus infections in dialysis units--a review. Reviews in medical virology, 1999; 9(2): p. 101-9.
2. Fabrizi F, Martin P, and Messa P, Hepatitis B and hepatitis C virus and chronic kidney disease. Acta gastro-enterologica Belgica, 2010; 73(4): p. 465-71.
3. Fabrizi F, Lunghi G, and Martin P, Hepatitis B virus infection in hemodialysis: recent discoveries. Journal of nephrology, 2002; 15(5): p. 463-8.
4. Fabrizi F, Poordad FF, and Martin P, Hepatitis C infection and the patient with end-stage renal disease. Hepatology, 2002; 36(1): p. 3-10.
5. World Health Organisation. Hepatitis B. World Health Organisation Fact Sheet 204 (Revised August 2008). 2008; [cited 2013 April 20]; Available from: http://www.who.int/mediacentre/factsheets/fs204/en/index.html.
6. UNAIDS., Report on the global HIV/AIDS epidemic, 2011; Joint United Nations Programme on HIV/AIDS: Geneva.
7. Fabrizi F, Messa P, and Martin P, Hepatitis B virus infection and the dialysis patient. Seminars in dialysis, 2008; 21(5): p. 440-6.
8. Madhava V, Burgess C, and Drucker E, Epidemiology of chronic hepatitis C virus infection in sub-Saharan Africa. The Lancet infectious diseases, 2002; 2(5): p. 293-302.
9. Jobarteh M, Malfroy M, Peterson I, Jeng A, Sarge-Njie R, Alabi A, et al., Seroprevalence of hepatitis B and C virus in HIV-1 and HIV-2 infected Gambians. Virology Journal, 2010; 7: p. 230.
10. Telaku S, Fejza H, Elezi Y, and Bicaj T, Hepatitis B and C in dialysis units in Kosova. Virology Journal, 2009; 6: p. 72.
11. Mbanya DN, Takam D, and Ndumbe PM, Serological findings amongst first-time blood donors in Yaounde, Cameroon: is safe donation a reality or a myth? Transfusion medicine, 2003; 13(5): p. 267-73.
12. Ndumbe PM and Skalsky J, Hepatitis C virus infection in different populations in Cameroon. Scandinavian journal of infectious diseases, 1993; 25(6): p. 689-92.
13. Kaze FF, Kengne AP, Choukem SP, Dzudie A, Halle MP, Dehayem MY, et al., Dialysis in Cameroon. American journal of kidney diseases : the official journal of the National Kidney Foundation, 2008; 51(6): p. 1072-4; author reply 1074.
14. Zahedi MJ, Darvish Moghaddam S, Alavian SM, and Dalili M, Seroprevalence of Hepatitis Viruses B, C, D and HIV Infection Among Hemodialysis Patients in Kerman Province, South-East Iran. Hepatitis monthly, 2012; 12(5): p. 339-43.
15. Su Y, Yan R, Duan Z, Norris JL, Wang L, Jiang Y, et al., Prevalence and risk factors of hepatitis C and B virus infections in hemodialysis patients and their spouses: a multicenter study in Beijing, China. J Med Virol, 2013; 85(3): p. 425-32.
16. Gasim GI, Hamdan HZ, Hamdan SZ, and Adam I, Epidemiology of hepatitis B and hepatitis C virus infections among hemodialysis patients in Khartoum, Sudan. Journal of medical virology, 2012; 84(1): p. 52-5.
17. Alashek WA, McIntyre CW, and Taal MW, Hepatitis B and C infection in haemodialysis patients in Libya: prevalence, incidence and risk factors. BMC infectious diseases, 2012; 12: p. 265.
18. Khosravani A, Sarkari B, Negahban H, Sharifi A, Toori MA, and Eilami O, Hepatitis B Infection among high risk population: a seroepidemiological survey in Southwest of Iran. BMC infectious diseases, 2012; 12: p. 378.
19. UNICEF, Cameroon statistic. Available on http://www.unicef.org/infobycountry/cameroon_statistics.html. Accessed on 27/08/2012, 2010.
20. Boulaajaj K, Elomari Y, Elmaliki B, Madkouri B, Zaid D, and Benchemsi N, [Prevalence of hepatitis C, hepatitis B and HIV infection among haemodialysis patients in Ibn-Rochd university hospital, Casablanca]. Nephrol Ther, 2005; 1(5): p. 274-84.
21. Bosevska G, Kuzmanovska G, Sikole A, Dzekova-Vidimilski P, and Polenakovic M, 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). Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za bioloski i medicinski nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences, 2009; 30(2): p. 159-74.