Nephrology Dialysis Transplantation, Vol 14, Issue 1 40-45, Copyright © 1999 by Oxford University Press
A Covic, L Iancu, C Apetrei, D Scripcaru, C Volovat, I Mititiuc and M Covic
Background: Although the epidemiology of hepatitis B
(HBV) and C (HCV) now seems well established for Western European
countries, in Central and Eastern Europe <50% of all dialysis
centres routinely test for hepatitis C antibodies since testing is not
available or is not applied to all patients. This study describes the
prevalence, risk factors and clinical significance of HBV and HCV infection
for the haemodialysis population of the North Eastern region of Romania,
Moldavia. Methods: The presence of HBV antigens was
determined with an ELISA kit (Wellcome, Abbot) and HCV antibodies with the
ELISA-3 Ortho-HCV, third generation test. The following individual data
were collected: gender, age, duration of dialysis, rural/urban domicile,
actual and previous HBV status, actual HCV status, known acute, clinically
evident hepatitis episodes in the last 3 years, monthly alanine
aminotransferase (ALAT) and aspartate aminotransferase (ASAT) levels,
complete biochemical hepatic assessment at the time of the study,
transfusions for the past 3 years and family history.
Results: HBV and HCV prevalences were 17% (stable over
the last 3 years) and 75%, respectively; co-infection was seen in 10% of
the subjects. Hospitalization (nosocomial infection) for HBV, blood
transfusions and duration on dialysis for HCV, emerged as the main risk
factors for hepatitis infection. Socio-economic conditions appear to be
equally important for HCV infection, since the prevalence was significantly
higher among patients from rural, underdeveloped areas than urban areas
(80.8 vs 70.3%), and infection was already present in
a large proportion of patients (47%) before starting dialysis, without
being related to previous disease duration or blood transfusion. HBV and/or
HCV was not associated with a worse clinical or biochemical profile at the
time of the study. However, infected patients had significantly more
previous cytolytic episodes, with higher, transient increases in ALAT and
ASAT levels. Conclusions: HCV infection is endemic
among dialysis centres in Moldavia. Apart from previously well-known risk
factors for hepatitis infection, our study demonstrates the negative impact
of socio-economic underdevelopment. Simple measures such as enforced
general asepsia rules, careful disinfection and equipment sterilization,
routine testing of patients from economically disadvantaged areas and
monthly, serial determination of hepatic enzymes should be the common
practice in dialysis centres in Romania. Key words:
epidemiology; haemodialysis; hepatitis B and C prevalence; risk factors
DIALYSIS AND TRANSPLANTATION NEWS
Hepatitis virus infection in haemodialysis patients from Moldavia
IV Medical Clinic, Nephrology, 'C. I. Parhon' Hospital, Department of Microbiology and Virusology, University of Medicine 'Gr. T. Popa', and Blood Transfusion Center, Iasi, Romania; Corresponding author at: IV Medical Clinic, Nephrology, 'C. I. Parhon' Hospital, Blvd. Copou, 50, Iasi, 6600, Romania
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  H Hinrichsen, G Leimenstoll, G Stegen, H Schrader, U R Folsch, and W E Schmidt Prevalence and risk factors of hepatitis C virus infection in haemodialysis patients: a multicentre study in 2796 patients Gut, September 1, 2002; 51(3): 429 - 433. [Abstract] [Full Text]
|
|