Saudi Journal of Kidney Diseases and Transplantation

ORIGINAL ARTICLE
Year
: 1995  |  Volume : 6  |  Issue : 2  |  Page : 154--156

Prevalence of Hepatitis C Virus Infection in Hemodialysis Patients in Sudan


Salma M Suliman1, Solomon Fessaha1, M El Sadig1, M Babiker El-Hadi1, Stephen Lambert2, Howard Fields2, Hashim W Ghalib3,  
1 Khartoum Kidney Dialysis Center, Sudan
2 Hepatitis Reference Lab Centers of Diseases Control (CDC) Clifton Road-Atlanta GA 30333, USA
3 Institute of Endemic Diseases, University of Khartoum, Sudan

Correspondence Address:
Salma M Suliman
Consultant Nephrologist, Khartoum Kidney Dialysis Center, PO Box 102
Sudan

Abstract

To estimate the prevalence of positivity of hepatitis C virus (HCV) antibodies in the hemodialysis population in Sudan and the risk factors of this infection in them we studied 46 hemodialysis patients (34 males, 12 females) in the Khartoum Kidney Dialysis Center (KKDC) in December 1994. Also we studied 37 healthy staff members in that unit. The blood of both groups was screened for HCV antibodies using a second generation ELISA test and confirmed by two bead supplemental assays. In the patients group, 16 cases (34.9%) were confirmed seropositive for HCV. There was a history of jaundice in four them. The mean duration on dialysis was 3.28 years in the HCV seropositive group compared with 2.2 years in the HCV seronegative group (P < 0.05). The mean frequency of blood transfusion was 2.68 units of blood in the HCV seropositive group, while it was 3.16 units in the HCV seronegative group which was not significantly different. Only two patients had high liver enzymes in the HCV seropositive groups, while there were seven patients with high liver enzymes in the HCV seronegative group. There were two staff members (5.41%) with positive HCV antibodies, but none had a history of jaundice or elevated liver enzymes. Both staff members were not involved in the direct patients care. We conclude that the prevalence of HCV antibody positivity was high in the hemodialysis population in Sudan. Nosocomial transmission may be the factor of transmission since we found no correlation with the blood transfusions.



How to cite this article:
Suliman SM, Fessaha S, El Sadig M, El-Hadi M B, Lambert S, Fields H, Ghalib HW. Prevalence of Hepatitis C Virus Infection in Hemodialysis Patients in Sudan.Saudi J Kidney Dis Transpl 1995;6:154-156


How to cite this URL:
Suliman SM, Fessaha S, El Sadig M, El-Hadi M B, Lambert S, Fields H, Ghalib HW. Prevalence of Hepatitis C Virus Infection in Hemodialysis Patients in Sudan. Saudi J Kidney Dis Transpl [serial online] 1995 [cited 2020 Apr 5 ];6:154-156
Available from: http://www.sjkdt.org/text.asp?1995/6/2/154/40858


Full Text

 Introduction



Hepatitis C virus (HCV) infection is highly prevalent in hemodialysis population in both the developed and the developing countries [1],[2] . The prevalence of this infection is not known in the hemodialysis population in Sudan. In our study we tried to estimate the prevalence rate in this population.

 Materials and Methods



We studied 46 hemodialysis patients (34 males, 12 Females) in the Khartoum Kidney Dialysis Center (KKDC) in Khartoum the capital of Sudan, in December 1994. Also we studied 37 healthy staff members working in that unit. Blood of both groups were screened for HCV antibodies using a second generation enzyme linked immunosorbent assay (ELISA) test, and confirmed by two bead supplemental assays [3],[4] . The separated sera were sent to the Center of Disease Control (CDC) Atlanta GA, USA.

The etiology of end-stage renal disease (ESRD) in the 46 studied patients is shown in [Table 1].

 Statistical analysis



We used the method of comparison of different data proportions where applicable, and the Student's "t" test to compare the mean values where applicable.

 Results



In the patients group 16 cases (34.9%) were confirmed positive for HCV antibodies. There was a history of jaundice in four of them (25%) compared with four patients (13.3%) in the negative HCV group, but the difference was not statistically significant. The mean duration on dialysis was 3.28 years in the HCV seropositive group compared with 2.2 years in the HCV seronegative group (P [1],[2],[5] . The nosocomial spread of infection was suggested in our study group, since we found no significant correlation with any history of blood transfusion, which was different from what was reported before [6] . We did not re-use the dialysers or the tubing. Our staff members who were working directly with the patients were HCV seronegative, which suggested the horizontal transmission between patients, as was reported before [7] . We did not practice isolation as suggested by some other studies [8] . We conclude that HCV infection was prevalent in KKDC, but did not cause a considerable morbidity among the study patients. Blood transfusions might not be the only route for HCV infection. Another study is going on, in the same center, to estimate the incidence of HCV infection.

 Acknowledgment



We would like to thank Mr. Steve Lambert in the CDC laboratory, also we would like to thank Mrs. Lilian Emeel Yousif and Ali Kamal Ali for preparing the manuscript.

References

1Annual report of management of renal failure in Europe XXIV, 1993. Vienna 1994.
2Padmanabhan R. Hepatitis C virus infection in hemodialysis patients in Saudi Arabia. Saudi J Kidney Dis Transplant 1994;5(2):157-8.
3Jadoul M, Cornu C, Van Y Persela de Strihou C. Incidence and risk factors for hepatitis C seroconversion in hemodialysis: a prospective study. The UCL Collaboration group. Kidney Int 1993;44(6):1322-6.
4Van der Poel CL, Cuypers HT, Reesink HW, et al. Confirmation of hepatitis C virus infection by new four-antigen recombinant immunoblot assay. Lancet 1991;337:317-9.
5Huraib S, Al-Rasheed R, Aldrees A, Al-jefry M, Arif M, Faleh FA. High prevalence and risk factors for Hepatitis C in Saudi Arabia: A need for new strategies in dialysis practice (abstract). Saudi Kid Dis Transplant Bull 1993;4(S1):73.
6Conway M, Catterall AP, Brown EA, et al. Prevalence of antibodies to hepatitis C in dialysis patients and transplant recipients with possible routes of transmission. Nephrol Dial Transplant 1992;7(12):1226-9.
7Colombo P, Filiberti O, Porcu M, et al. Prevalence of hepatitis C infection in a hemodialysis unit. Nephron 1992;61(3):326-7.
8Saeed AA, Suleiman M, Al-Khader A, Al-Rasheed AM, Rankin D, Mcomish F. PCR confirmation of hepatitis C viraemia among hemodialysis patients. The need for an isolation policy (abstract) Saudi Kidney Dis Transplant Bull 1993;4(S1);74.