Predictors of hcv seroconversion among end-stage renal disease patients in hemodialysis unit

Abstract

Background: In patients under dialysis, blood borne infections remains one of the mostpublic causes of morbidity, hospitalization and death. Among dialysis patient's long-term hemodialysis (HD) therapy, frequency of blood transfusions and multiple blood transfusions enhance the risk of acquiring blood-borne infections. Objective: The aim of the study was to identify predictors for HCV seroconversion in HD patients. Method: Prospective observational study was conducted on 173 Chronic kidney disease (CKD) patients undergoing HD. Anti HCV antibody testing was accomplished at the start of study and every 2-3 months subsequently. To identify seroconversion, patients who were sero-negative for HCV were monitored. Results: Prospective follow-up exposed an occurrence of seroconversion of 12.1% during study duration. On multivariate analysis, both increase in the duration on hemodialysis besides attending more than one centre for HD were significantly associated with anti-HCV positivity (p< 0.05, OR 0.185), (p< 0.05, OR 4.52) respectively. Risk factors blood transfusion and AST >40 IU/L also shows significant association for seroconversion (p< 0.05). Conclusion: It is concluded that increase post dialysis incidence of HCV occurs as specific guidelines for HCV infected patients were not followed. Regular surveillance for HCV infection helps dramatically in decreasing the spread of HCV in hemodialysis unit.