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Saudi Journal of Kidney Diseases and Transplantation
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RENAL DATA FROM THE ASIA - AFRICA Table of Contents   
Year : 2008  |  Volume : 19  |  Issue : 3  |  Page : 466-469
Survey of Hepatitis B Status in Hemodialysis Patients in a Training Hospital in Urmia, Iran


1 Department of Virology, Urmia University of Medical Sciences, Urmia, Iran
2 Medical Student, Urmia University of Medical Sciences, Urmia, Iran

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   Abstract 

To evaluate the prevalence of HBV infection in chronic hemodialysis patients at our dialysis center of Urmia's Taleqni Hospital, Urmia, Iran, we studied cross­sectionally the hepatitis surface antigen (HbsAg) status in blood samples of 167 active chronic hemodialysis patients at our center with enzyme linked immunosorbant assay (ELISA). The mean frequency of HbsAg+ was 6.58%, which was higher in patients less than 50 years old than in those above 50 years (9.3% vs. 5.3%, respectively), in males than females (10.5% vs. 2.5%, respectively), and in those on three times dialysis than twice per week (7.1% vs. 0.0%, respectively). We did not find a significant relationship between the factors of: age, sex, being resident in city or village, duration of the therapy, history of blood transfusion, marital status, job status, history of kidney transplantation, and preva­lence of HbsAg+.

Keywords: Renal, Hepatitis B, Hemodialysis, Iran

How to cite this article:
Khameneh ZR, Sepehrvand N. Survey of Hepatitis B Status in Hemodialysis Patients in a Training Hospital in Urmia, Iran. Saudi J Kidney Dis Transpl 2008;19:466-9

How to cite this URL:
Khameneh ZR, Sepehrvand N. Survey of Hepatitis B Status in Hemodialysis Patients in a Training Hospital in Urmia, Iran. Saudi J Kidney Dis Transpl [serial online] 2008 [cited 2019 Nov 18];19:466-9. Available from: http://www.sjkdt.org/text.asp?2008/19/3/466/40516

   Introduction Top


More than one-third of the world popu­lation is infected with HBV. WHO assumes that 1 - 2 million patients die each year because of HBV complications. Individuals who remain hepatitis antigen positive (Hbs Ag+) for more than six month are consi­dered chronic transmitters. [1]

It is assumed that there are 350 million humans as chronic transmitters of HBV. Moreover, different parts of the world are categorized into three regions according to prevalence of HbsAg+: low with less than 2%, intermediate with 2% to 7%, and high with more than 7%.

The percentage of prevalence of HbsAg+ in Iran is 1.5% to 6.5%. Accordingly, Iran is in the intermediate group of the world in the prevalence of HBsAg+. [2] However, the prevalence of HBsAg+ in Azarbaijan pro­vince in the west of Iran was reported as 0.9%. [3]

Hemodialysis patients are a high risk po­pulation for HBV infection. [4] On the other hand, immunodeficiency may be the cause of the high prevalence in this population. Patients under long-term and continuous hemodialysis sessions are under high risk of being infected with HBV. [5]

This study aims at evaluating the status of HBV infection among active chronic he­modialysis patients at the dialysis unit of Urmia Taleqani Hospital, Urmia, Iran, to determine prevalence of this infection and the related risk factors.


   Materials and Methods Top


We studied cross-sectionally the hepatitis surface antigen (HbsAg) status in blood samples of 167 (51% males) active chronic hemodialysis patients at our center with en­zyme linked immunosorbant assay (ELISA). Of the study patients 48 (28%) were on hemodialysis for less than 2 years, 85 (50%) from 2-5 years, and 34 (20%) were for more than 5 years; 154 patients were on 3- 4 times hemodialysis schedule per week. In addition, 135 (80%) patients were resident in a city and 88 (16.7%) in a village; we did not have any information about 4 of them. There were 141 (84%) patients who were married, 14 (8.3%) single, 9 (5.3%) widow, and 3 (1%) who did not mention their ma­rital status. There were 139 (83%) patients with a positive history of blood transfusion, while 28 (13.2%) patients did not mention their transfusion history. Of the study pa­tients, 90 (53%) patients were illiterate, while 77 (48%) were literate (38% primary school, 12% guidance school, 40% high school, 7% university degree). There were 114 (68%) patients who had no job, 30 (11.9%) had free jobs, and 23 (13.7%) were employed. There were 143 (85%) patients who did not receive any history of kidney trans­plantation, while 24 (14.3%) received a kid­ney transplant with failed allograft in the past.

We studied the medical records of the study patients according to a questionnaire that included the clinical and investigation­nal data, and we correlated them with the results of the HbsAg status.


   Statistical analysis Top


We analyzed the data using SPSS software version 11. The results were represented by graphs and tables. We used chi-square test and student's "t" test for comparison of the data.


   Results Top


HbsAg+ was positive in 11 (6.58%) hemo­dialysis patients. The mean percentage of HbsAg+ was higher in patients less than 50 years old than in those above 50 (9.3%, 5.3%, respectively), in males than females (10.5%, 2.5%, respectively), in patients who lived in a city than those who lived in a village (7.4%, 3.6%, respectively), in pa­tients less than 2 years on dialysis than those between 2-5 years and more than 5 years (42%, 8.2%, and 5.9%, respectively), in patients on three times dialysis than twice per week (7.1%, 0.0%, respectively), in patients who had history of blood trans­fusions than who did not (7.2%, 0.0%), in patients who were married than single or widow (7.8%, 0.0%, 0.0%, respectively), in the illiterate patients than the literate (7.8%, 5.2%, respectively), in patients who were employed than those who held free jobs, or were unemployed (8.7%, 6.7%, 6.1%, respectively), and in patients who had history of transplantation than those who did not (8.3%, 6.3%, respectively).

Finally, we did not find a significant rela­tionship between the factors of: age, sex, being resident in city or village, duration of the therapy, history of blood transfusion, marital status, job status, history of kidney transplantation, and prevalence of HbsAg+.


   Discussion Top


The prevalence of HbsAg+ among hemo­dialysis patients referred to the hemodia­lysis unit at our hospital was 6.5 %. There was no significant difference with the re­sults of the pervious surveys from Iran, [2],[3] Brazil, [6],[7],[8],[9] India, [10] Kenya, [11] Bahrain, [12] Bir­jand, [13] Tehran, [14] and Kurdistan-Iran. [15]

There were no significant correlations with the major known risk factors such as age, sex, being resident in city or village, dura­tion of the therapy, history of blood trans­fusion, marital status, job status, history of kidney transplantation, and prevalence of HbsAg+. However, Busek et al have reported a cohort of 434 dialysis patients with HbsAg+ prevalence of 5.9% to 0% in Brazil and found several HBV infection risk factors that included the number of patients per each hemodialysis unit, period of the therapy, number of the clinicians involved, number of the transfused blood units, and poor vascular condition. [16] Moreover, Sabour B et al found a signi­ficant relationship between prevalence of HCV infection and the factors: period of hemodialysis, history of blood transfusion, history of kidney transplantation or surgical operation. [17]

 
   References Top

1.Robinson WS, Hepadnaviridea, Mandel GL, principles and practice infectious disease, 5 th ed, USA, Churchill Livingstone, 2000:1962.  Back to cited text no. 1    
2.Study of protective effects of HBV vaccine in national vaccination program: Scientific magazine of IRI medical council. 1999;17 (2):128-131  Back to cited text no. 2    
3.Mandel text book, 1995;2623-4,2776-7, 1428-9.  Back to cited text no. 3    
4.Dienstag JL, Lsselbacher KJ. Acute viral hepatitis, Harrison's principles of internal medicine, 14 th USA, McGraw-Hill Com­panies, 1998:1655.  Back to cited text no. 4    
5.Slizien w,manitius J, Rutkowski B, et al Evaluation of prophylaxis and actual prevalence of HBV infection in twelve hemodialysis centers of Northern Pland. Pol Arch Med Wewn 1997;98(7):39-48.  Back to cited text no. 5    
6.Souza KP, Luz JA, Teles SA, et al. Hepatitis B and C in the hemodialysis unit of Tocantins, Brazil: Serological and molecular profiles. Men Inst Oswaldo Cruz 2003;98(5):599-603.  Back to cited text no. 6    
7.Teles SA, Martins RM, Silva SA, et al. Hepatitis B virus infection profile in central Brazilian hemodialysis population. Rev Inst Med Trop Sao Paulo 1998; 40(5):281-6.  Back to cited text no. 7    
8.Carrilho FJ, Moraes CR, Pinho JR, et al. Hepatitis B virus infection in hemodialysis centres from Santa Catarina state, Southern Brazil. BMC Public Health 2004; 4:13.  Back to cited text no. 8  [PUBMED]  [FULLTEXT]
9.Lewis-Ximenez LL, Oliveira JM, Mercadante LA, et al. Serological and vaccination profile of hemodialysis patients during an outbreak of hepatitis B virus infection. Nephron 2001;87(1):19-26.  Back to cited text no. 9    
10.Reddy GA, Dakshinamurthy KV, Neelaprasad P, Gangadhar T, Lakshmi V. Prevalence of HBV and HCV dual infection in patients on hemodialysis. Indian J Med Microbiol 2005;23(1):41-3.  Back to cited text no. 10    
11.Otedo AE, McLigeyo SO, Okoth FA, Kayima JK. Seroprevalence of hepatitis B and C in maintenance dialysis in a public hospital in a developing country. S Afr Med J 2003;93(5):380-4.  Back to cited text no. 11    
12.Qadi AA, Tamim H, Ameen G, et al. Hepatitis B and hepatitis C virus prevalence among dialysis patients in Bahrain and Saudi Arabia: A survey by serologic and molecular methods. Am J Infect Control 2004;32(8):493-5.  Back to cited text no. 12    
13.Prevalence of HbsAg+ in patients with chronic renal failure referred to Imam Reza hospital of Birjand before starting the hemodialysis. Sci Mag Birjand Med Uni 1999;6(1,2):1-5.  Back to cited text no. 13    
14.Evaluation of HBV status in patients under chronic hemodialysis in Tehran province. Pajuhandeh 2000;5(20):429-33.  Back to cited text no. 14    
15.Survey about prevalence of HBV in Kordestan. Sci Mag Kurdistan Med Uni 2002;6(4):24-5.  Back to cited text no. 15    
16.Busek SU, Baba EH, Tavares Filho HA, et al. Hepatitis C and hepatitis B virus infection in different hemodialysis units in Belo Horizonte, Minas Gerais, Brazil. Mem Inst Oswaldo Cruz 2002;97(6):775-8.  Back to cited text no. 16    
17.Survey about prevalence of HCV and distribution of assisting factors in hemo­dialysis patients in Kermanshah. Behbood 2003;7(18):60-6.  Back to cited text no. 17    

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Correspondence Address:
Zakieh Rostamzadeh Khameneh
Assistant Professor in Virology, Urmia University of Medical Sciences, Urmia
Iran
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PMID: 18445915

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    Abstract
    Introduction
    Materials and Me...
    Statistical analysis
    Results
    Discussion
    References
 

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