Hepatitis B and C Viral Infections among Dialysis Patients and Related Factors of Dialysis Centres in Saudi Arabia

Abstract

Introduction: Viral Hepatitis is a global disease, affecting millions of patients around the world. Dialysis dependent patients use an artificial kidney (haemodialyser) to remove waste product from the blood in severe renal impairment patients. Hence, they are more vulnerable to viral hepatitis. Aim: To investigate the prevalence of hepatitis B and C infections among dialysis patients and related factors of dialysis centres in the Qassim province, Saudi Arabia. Materials and Methods: This cross-sectional study, reviewed the medical records of 707 patients from the data registry of 18 affiliated dialysis centres across Al Qassim region of Saudi Arabia, during August 2017 to August 2018. A detailed questionnaire regarding the general information about the dialysis centre, isolation and screen status, vaccination status, and vascular access was completed by the Dialysis Centre Manager of all the 18 affiliated centres. The details of Hepatitis B Surface Antigen (HBsAg) and Hepatitis C Virus (HCV) serology reports were extracted to establish the prevalence and epidemiological profile of these patients. Descriptive analysis was conducted where numbers and percentages were used to summarise all categorical variables. Results: The majority 14 (77.8%) of the centres were government entities and the rest were for profit centres. Out of the 18 centres, 10 (55.6%) were hospital based, 5 (27.8%) were free-standing and 3 (16.7%) were free-standing but owned by a hospital. The prevalence of HBsAg positive cases among incentre haemodialysis patients was 3.2% and the prevalence of Hepatitis C (HBC) antibody positive cases was 6.4% with 0.3% cases of the HBsAg and HBC converted to positive during the previous 12 months. Conclusion: The incidence of hepatitis B and C positivity was common in patients receiving haemodialysis. The study found low prevalence of both Hepatitis B and C positive cases in comparison to several published articles. The decrease in HBV and HBC prevalence seen in the present study may be attributable to the development and implementation of preventive strategies, increased adherence by medical staff to aseptic measures, better infection management, immunisation, and isolation of affected patients. However, further studies are needed to generalise the outcome of the present study.

Keywords

• haemodialysis
• vaccination status
• vascular access