Seroprevalence of Hepatitis B, C and coinfection among patients with chronic kidney disease in a Nigerian hospital

Abstract

Infectious diseases remain a major health challenge in developing countries, compounding the woes of growing noncommunicable diseases such as chronic kidney disease (CKD). Increased morbidity and mortality have been reported among CKD patients with hepatitis infection and may necessitate protocol for treatment, follow-up, and prevention of spread. We aimed to determine the prevalence of viral hepatitis B and C infections among CKD patients and the effects on their liver enzymes. In this retrospective study, 314 CKD patients screened for hepatitis C virus (HCV) and hepatitis B surface antigen (HBsAg) were reviewed. Participants were screened at the time of diagnosis of CKD or referral, using qualitative enzyme immunoassay rapid test kits before the initiation of treatment. Individuals who were reactive to human immunodeficiency virus were excluded, and data were analyzed using IBM SPSS Statistics version 21.0. Participants included 206 males (65.6%) and 108 females (34.4%), with a mean age of 50.5 ± 16.3 years. The seroprevalence of HBsAg, HCV, and coinfection was seen in 15.6% (49), 4.8% (15), and 0.92% of the patients, respectively. More than half (63.6%) of the seropositive patients were below 50 years of age. Alanine transaminase (ALT) activity was higher in HCV seropositive than negative (10.5 ± 10.5 vs. 21.2 ± 35.9) (P = 0.001), while aspartate transaminase (AST) and alkaline phosphatase (ALP) were similar. ALT, AST, and ALP were also similar between HBsAg-seropositive and HBsAg-negative patients. The prevalence of hepatitis B and C is high among our CKD patients. This suggests the need for improved screening and treatment of hepatitis infection in this group. Immunization may also be essential to prevent its spread among patients requiring hemodialysis.