Study On HCV / HBV Infection And Its Influencing Factors In Hemodialysis Population And Their Spouses In Beijing

Background Hemodialysis patients are at risk for hepatitis C and B infections, and the prevalence of HCV and HBV infection among hemodialysis patients are relatively higher than general population. The two viruses are important agents of liver damage, which causes morbidity and mortality in patients on hemodialysis. Therefore, strengthened understanding of the HCV/HBV epidemics among hemodialysis patients and the associated risk factors will benefit the following prevention and control work.Objectives To investigate the prevalence and risk factors of HCV and HBV infection and the distribution of HCV genotypes among hemodialysis patients and their spouses.Methods From August to November2011, a cross-sectional study was conducted in20hemodialysis units in Beijing to investigate prevalence and risk factors for markers of HCV and HBV among2,120patients and409spouses.Results1. The prevalence for HCV and HBV infection in hemodialysis patients.2120hemodialysis patients were recruited in this study, and the prevalence of anti-HCV, HCV RNA and HBsAg antibodies were6.08%,4.76%and6.98%respectively. Among them,1,242patients (58.58%) also had anti-HBs、HBeAg、anti-HBe and anti-HBc tests.38.57%patients were positive for HBsAb,2.09%for HBeAg,13.12%for HBeAb, and50.89%for HBcAb. The predominant HCV genotypes were lb (89.01%) and2a (7.69%), and genotypes3a,3b and6a were each1.10%.2. The prevalence for HCV and HBV infection in spouses.409spouses were recruited in this study, and the prevalence of anti-HCV antibodies among spouses was0.49%, of HCV RNA was0.24%, of HBsAg was4.16%. All spouses have anti-HBs、HBeAg、anti-Hbe、anti-HBc tests. The prevalence among spouses was42.40%for anti-HBs,0.74%for HBeAg,7.60%for anti-HBe, and43.38%for anti-HBc. The HCV genotype of the one spouse whose HCV RNA was positive was1b.3. Risk factors for HCV infection. The risk factors for HCV were dialysis duration、 blood transfusion and attending more than one dialysis unit(adjusted ORantibody=2.26,95%CI:1.47～3.48; adjusted ORRNA=2.29,95%CI:1.41-3.74) It was found that the prevalence of anti-HCV increased with length of time on hemodialysis. Compared with non-blood transfusions, patients who had received blood transfusions before1998(adjusted ORantibody=6.27,95%CI:3.56～11.06; adjusted ORRNA=7.23,95%CI:3.74-13.99) had a higher risk of HCV infection than those who received transfusions after1998(adjusted ORaniibody=2.28,95%CI:1.46-3.48; adjusted ORRNA=2.60,95%CI:1.37-4.93).4. Risk factors for HCV infections. HBV infection among hemodialysis patients was independently associated with age、family member with hepatitis infection (adjust OR=7.17,95%CI:4.25～12.10)、gender (adjust OR=1.73,95%CI:1.20～2.51) and surgery (adjust OR=3.05,95%CI:1.53～6.11).Conclusions The prevalvence of anti-HCV among hemodialysis in Beijing was significant higher than general population, however, the prevalence of anti-HCV among hemodialysis patients in this study was significantly lower than previously reported in Beijing. HBV infection control measures in hospitals in Beijing are effective, for prevalence of HBsAg in patients on hemodialysis was close to that reported in the general population and lower than that in other cities. For HCV infection, dialysis duration and blood transfusion are the major risk factors, while family member hepatitis infection and surgery are independently associated with HBV infection. By investigating patients’spouses, it was found that the risk of HCV transmission from household contacts and sexual partners was low or even null. The predominant genotype of HCV in hemodialysis patients was1b, which confirmed that patients are infected mainly through nosocomial transmission.