Article information
Abstract
Background
Hepatitis C virus (HCV) infection is the most common cause of acute or chronic hepatitis in patients on hemodialysis (HD). The purpose of this study was to describe the prevalence of positive HCV RNA and investigate injection drug use as an emerging risk factor in patients with chronic renal disease on HD.
MethodsThis was a multicenter cross-sectional study with 325 patients with chronic renal disease on HD in the period between August 1, 2005 to August 30, 2006, receiving care at four institutions in the city of Porto Alegre, Southern Brazil. Epidemiological data were collected by means of a structured questionnaire. The following laboratory tests were performed: alanine aminotransferase (ALT), anti-hepatitis C virus antibodies (anti-HCV), and qualitative polymerase chain reaction (PCR).
ResultsOf 325 patients, 68 had positive HCV RNA results. The comparison between patients with positive and negative PCR results revealed signifi cant differences in duration of HD (mean = 71 versus 52.4 months; p = 0.02); previous blood transfusion (92% versus 72%; p < 0.01); injection drug use (13% versus 0.7%; p < 0.01); anti-HCV positivity at start of HD therapy (60% versus 4%; p < 0.01); and mean ALT value (39 versus 26.5; p < 0.01). Logistic regression analysis showed a positive HCV RNA independently associated to being on HD for more than five years [OR: 2.1 (95% CI 1.2 - 3.8)]; previous blood transfusion [OR: 3.7 (95% CI 1.4 - 9.5)]; and injection drug use [OR: 22.6 (95% CI 4.2 - 119.6)].
ConclusionInjection drug use was an independent risk factor for HCV infection among chronic renal disease patients on HD.
Keywords:
hepatitis C virus
hemodialysis
injection drug use
risk factors
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References
[1.]
F. Fabrizi, F.F. Poordad, P. Martin.
Hepatitis C infection and patient with end-stage renal disease.
Hepatology, 36 (2002), pp. 3-10
[2.]
B.J. Pereira, A.S. Levey.
Hepatitis C virus infection in dialysis and renal transplantation.
Kidney Int, 51 (1997), pp. 981-999
[3.]
Recommendations for preventing transmission of infections among chronic hemodialysis patients.
MMWR Recomm Rep, 50 (2001), pp. 1-43
[4.]
M. Sampietro, S. Badalamenti, G. Graziani.
Nosocomial hepatitis C in dialysis units.
Nephron, 74 (1996), pp. 251-260
[5.]
R.B. Fissell, J.L. Bragg-Gresham, J.D. Woods, et al.
Patterns of hepatitis C prevalence and seroconversion in hemodialysis units from three continents: the DOPPS.
Kidney Int, 65 (2004), pp. 2335-2342
[6.]
J.E. Romão Jr., S.W.L. Pinto, M.E. Canziani, et al.
Brazilian Society of Nephrologys (SBN) annual survey report on epidemiology of dialysis facilities in Brazil.
J Bras Nefrol, 25 (2003), pp. 187-198
[7.]
R. Moreira, J.R. Pinho, J. Fares, et al.
Prospective study of hepatitis C virus infection in hemodialysis patients by monthly analysis of HCV RNA and antibodies.
Can J Macrobiol, 49 (2003), pp. 503-507
[8.]
M.A. Carneiro, R.M. Martins, S.A. Teles, et al.
Hepatitis C prevalence and risk factors in hemodialysis patients in central Brazil: a survey by polymerase chain reaction and serological methods.
Mem Inst Oswaldo Cruz, 96 (2001), pp. 765-769
[9.]
S.U. Busek, E.H. Babá, H.A. Tavares Filho, et al.
Hepatitis C and hepatitis B virus infection in different hemodialysis units in Belo Horizonte, Minas Gerais, Brazil.
Mem Inst Oswaldo Cruz, 97 (2002), pp. 775-778
[10.]
K.P. Souza, J.A. Luz, S.A. Teles, M.A. Carneiro, L.A. Oliveira.
Hepatitis B and C in the hemodialysis unit of Tocantins, Brazil: serological and molecular profi les.
Mem Inst Oswaldo Cruz, 98 (2003), pp. 599-603
[11.]
E.C. Gouveia, E.P.A. Lopes, I. Moura, et al.
Identifi cation of the cutoff value for serum alanine aminotransferase in hepatitis C screening of patients with chronic renal failure on hemodialysis.
Rev Soc Bras Med Trop, 37 (2004), pp. 18-21
[12.]
S.K. Ono-Nita, C.R. de Moraes, F.J. Carrilho, et al.
A prospective study of the prevalence of hepatitis B and C virus coinfection among patients with chronic renal disease under hemodialysis.
J Hepatol, 40 (2004), pp. 715-716
[13.]
A.C. Albuquerque, M.R. Coêlho, E.P. Lopes, M.F. Lemos, R.C. Moreira.
Prevalence and risk factors of hepatitis C virus infection in hemodialysis patients from one center in Recife, Brazil.
Mem Inst Oswaldo Cruz, 100 (2005), pp. 467-470
[14.]
C. Karohl, R.C. Manfro, M.B. Senger, et al.
Prevalência de antivírus da hepatite C em pacientes em hemodiálise crônica de Porto Alegre.
J Bras Nefrol, 17 (1995), pp. 40-46
[15.]
A.L. Flores, A.A. Mattos, J.C. Goldani, et al.
Marcadores virais da hepatite em uma unidade de hemodiálise.
GED, 16 (1997), pp. 190
[16.]
M.A. Dotta, H. Chequer, J.P. Pereira, et al.
Molecular and immunological methods in the diagnosis of hepatitis C virus in patients on hemodialysis.
J Bras Nefrol, 25 (2003), pp. 86-94
[17.]
C.V. Lopes, T. Karnopp, J.E. Burmeister, et al.
Detection of hepatitis C by polymerase chain reaction in chronic renal patients in hemodialysis and non-reagent anti-VHC.
GED, 24 (2005), pp. 1-5
[18.]
W.H. Hörl.
Neutrophil function and infections in uremia.
Am J Kidney Dis, 33 (1999), pp. 45-48
[19.]
J.I. Tokars, M.J. Alter, M.S. Favero, et al.
National surveillance of dialysis associated diseases in the United States, 1992.
ASAIO J, 40 (1994), pp. 1020-1031
[20.]
S. Bergman, N. Accortt, A. Turner, J. Glaze.
Hepatitis C infection is acquired pre-ESRD.
Am J Kidney Dis, 45 (2005), pp. 684-689
[21.]
M.J. Alter.
Prevention of spread of hepatitis C.
Hepatology, 36 (2002), pp. 93-98
[22.]
J.A. van den Hoek, H.J. van Haastrecht, J. Goudsmit, F. de Wolf, R.A. Coutinho.
Prevalence, incidence, and risk factors of hepatitis C virus infection among drug users in Amsterdam.
J Infect Dis, 162 (1990), pp. 823-826
[23.]
D.G. Woodfi eld, M. Harness, K. Rix-Trott.
Hepatitis C virus infections in oral and injectable drug users.
N Z Med J, 106 (1993), pp. 332-334
[24.]
D.G. Woodfi eld, M. Harness, K. Rix-Trott, et al.
Identifi cation and genotyping of hepatitis C virus in injectable and oral drug users in New Zealand.
Aust N Z J Med, 24 (1994), pp. 47-50
[25.]
C. Apichartpiyakul, C. Chittivudikarn, H. Miyajima, M. Homma, H. Hotta.
Analysis of hepatitis C virus isolates among healthy blood donors and drug addicts in Chiang May, Thailand.
J Clin Microbiol, 32 (1994), pp. 2276-2279
[26.]
D.L. Thomas, D. Vlahov, L. Solomon, et al.
Correlates of hepatitis C virus infections among injection drug users.
Medicine (Baltimore), 74 (1995), pp. 212-220
[27.]
O.E. Santana Rodríguez, M.L. Malé Gil, J.F. Hernández Santana, J.M. Limiñana Cañal, A.M. Martín Sanchez.
Prevalence of serologic markers of HBV, HDV, HCV and HIV in non-injection drug users compared to injection drug users in Gran Canaria. Spain.
Eur J Epidemiol, 14 (1998), pp. 555-561
[28.]
B.P. Smyth, E. Keenan, J.J. O’Connor.
Bloodborne viral infection in Irish injecting drug users.
Addiction, 93 (1998), pp. 1649-1656
[29.]
H.B. de Carvalho, F. Mesquita, E. Massad, et al.
HIV and infections of similar transmission patterns in a drug injectors community of Santos, Brazil.
J Acquir Immune Defi c Syndr Hum Retrovirol, 12 (1996), pp. 84-92
[30.]
M.L. Oliveira, F.I. Bastos, P.R. Telles, et al.
Prevalence and risk factors for HBV, HCV and HDV infections among injecting drug users from Rio de Janeiro, Brazil.
Braz J Med Biol Res, 32 (1999), pp. 1107-1114
[31.]
A. Treitinger, C. Spada, E.L. Silva, et al.
Prevalence of serologic markers of HBV and HCV infection in HIV-1 seropositive patients in Florianópolis, Brazil.
Braz J Infect Dis, 3 (1999), pp. 1-5
[32.]
C.O. Stehman-Breen, S. Emerson, D. Gretch, R.J. Johnson.
Risk of death among chronic dialysis patients infected with hepatitis C virus.
Am J Kidney Dis, 32 (1998), pp. 629-634
[33.]
N. Petrosillo, P. Gilli, D. Serraino, et al.
Prevalence of infected patients and understaffi ng have a role in hepatitis C virus transmission in dialysis.
Am J Kidney Dis, 37 (2001), pp. 1004-1010
[34.]
J. Sandhu, J.K. Preiksaitis, P.M. Campbell, K.C. Carriere, P.A. Hessel.
Hepatitis C prevalence and risk factors in the northern Alberta dialysis population.
Am J Epidemiol, 150 (1999), pp. 58-66
[35.]
M. Jadoul.
Epidemiology and mechanisms of transmission of the hepatitis C virus in haemodialysis.
Nephrol Dial Transplant, 15 (2000), pp. 39-41
[36.]
P.M. Schneeberger, I. Keur, W. van der Vliet, et al.
Hepatitis C virus infection in dialysis centers in the Netherlands: a national survey by serological and molecular methods.
J Clin Microbiol, 36 (1998), pp. 1711-1715
[37.]
G. Salama, L. Rostaing, K. Sandres, J. Izopet.
Hepatitis C virus infection in French hemodialysis units: a multicenter study.
J Med Virol, 61 (2000), pp. 44-51
[38.]
J. Bukh, P. Wantzin, K. Krogsgaard, et al.
High prevalence of hepatitis C virus (HCV) RNA in dialysis patients: failure of commercially available antibody tests to identify a signifi cant number of patients with HCV infection. Copenhagen Dialysis HCV Study Group.
J Infect Dis, 168 (1993), pp. 1343-1348
[39.]
M. Carvalho, P.B. Branco, M.L. Luvizotto, et al.
High prevalence of hepatitis C virus infection in chronic hemodialysis patients.
Braz J Infect Dis, 3 (1999), pp. 144-148
[40.]
L.K. Silva, M.B. Silva, I.F. Rodart, et al.
Prevalence of hepatitis C virus (HCV) infection and HCV genotypes of hemodialysis patients in Salvador. Northeastern Brazil.
Braz J Med Biol Res, 39 (2006), pp. 595-602
[41.]
J. Kumagai, Y. Komiya, J. Tanaka, et al.
Hepatitis C virus infection in 2,744 hemodialysis patients followed regularly at nine centers in Hiroshima during November 1999 through February 2003.
J Med Virol, 76 (2005), pp. 498-502
[42.]
G.O. Santana, H.P. Cotrim, E. Mota, et al.
Anticorpo contra o vírus C da hepatite em pacientes sob programa de hemodiálise em Salvador, BA, Brasil.
Arq Gastroenterol, 38 (2001), pp. 24-31
[43.]
S. Kellerman, M.J. Alter.
Preventing hepatitis B and hepatitis C virus infections in end-stage renal disease patients: back to basics.
Hepatology, 29 (1999), pp. 291-293
[44.]
L.A. Moyer, M.J. Alter.
Hepatitis C virus in the hemodialysis setting: a review with recommendations for control.
Semin Dial, 7 (1994), pp. 124-127
[45.]
S. Le Pogam, D. Le Chapois, R. Christen, et al.
Hepatitis C in a hemodialysis unit: molecular evidence for nosocomial transmission.
J Clin Microbiol, 36 (1998), pp. 3040-3043
[46.]
N.M. Hardy, S. Sandroni, S. Danielson, W.J. Wilson.
Antibody to hepatitis C virus increases with time on hemodialysis.
Clin Nephrol, 38 (1992), pp. 44-48
[47.]
M.T. Niu, P.J. Coleman, M.J. Alter.
Multicenter study of hepatitis C virus infection in chronic hemodialysis patients and hemodialysis center staff members.
Am J Kidney Dis, 22 (1993), pp. 568-573
[48.]
S.M. Alavian, B. Einollahi, B. Hajarizadeh, et al.
Prevalence of hepatitis C virus infection and related risk factors among Iranian haemodialysis patients.
Nephrology (Carlton), 8 (2003), pp. 256-260
[49.]
H. Hinrichsen, G. Leimenstoll, G. Stegen, et al.
Prevalence and risk factors of hepatitis C virus infection in haemodialysis patients: a multicentre study in 2796 patients.
Gut, 51 (2002), pp. 429-433
[50.]
M.A. Carneiro, S.A. Teles, M.A. Dias, et al.
Decline of hepatitis C infection in hemodialysis patients in Central Brazil: a ten years of surveillance.
Mem Inst Oswaldo Cruz, 100 (2005), pp. 345-349
[51.]
C.J. Gresens, P.V. Holland.
The disappearance of transfusion-transmitted hepatitis C virus infections in the United States.
Clin Liver Dis, 5 (2001), pp. 1105-1113
[52.]
M. Jadoul, C. Cornu, C. van Ypersele de Strihou.
Incidence and risk factors for hepatitis C seroconversion in hemodialysis: a prospective study. The UCL Collaborative Group.
Kidney Int, 44 (1993), pp. 1322-1326
[53.]
B. Galperim, H. Cheinquer, A. Stein, et al.
Intranasal cocaine use does not appear to be an independent risk factor for HCV infection.
Addiction, 99 (2004), pp. 973-977
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