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Frequency and Genotype of Hepatitis D Virus Infection in Patients Infected with HIV and Those Undergoing Hemodialysis.

ABSTRACT: BACKGROUND:Hepatitis D virus (HDV) is a defective virus dependent on hepatitis B virus (HBV) for its replication. Due to HDV transmission routes, patients undergoing hemodialysis and those with HIV infection are at risk of acquiring HDV. OBJECTIVES:This study was aimed to determine the frequency and genotype of HDV infection among patients with HIV infection and those undergoing hemodialysis. PATIENTS AND METHODS:720 cases including 120 patients undergoing hemodialysis, and 600 patients with HIV infection were studied. All cases with positive results for HBsAg were evaluated for the presence of anti-HDV antibodies. Samples with Anti-HDV positive results were subjected to nested PCR for HDV-RNA confirmation, and sequenced for HDV genotype determination. RESULTS:HBsAg was found in 9 (7.5%) of 120 patients undergoing hemodialysis, and 9 (1.5%) of 600 patients with HIV infection. 3 (33.3%) of patients undergoing hemodialysis with positive results for HBsAg, and 5 (55.5%) of cases with HIV infection and positive results for HBsAg, had positive findings for anti-HDV which were then subjected to nested PCR. The amplification results confirmed that in 3 (37.5%) samples HDV-RNA was detected. Overall 2.5% of patients undergoing hemodialysis, and 0.8% of cases infected with HIV had positive results for anti-HDV and 1.7% and 0.2% of cases undergoing hemodialysis and patients infected with HIV had positive findings for HDV-RNA respectively. All of the HDV isolates were clustered in clade 1. CONCLUSIONS:The survey showed that overall HDV frequency was not high in our high risk cases. Therefore, practitioners and health care managers should become aware of the risk of dual infection with HBV and HDV especially in high risk patients.

SUBMITTER: Aghasadeghi MR

PROVIDER: S-EPMC3728973 | biostudies-literature | 2013 May

REPOSITORIES: biostudies-literature

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Frequency and Genotype of Hepatitis D Virus Infection in Patients Infected with HIV and Those Undergoing Hemodialysis.

Aghasadeghi Mohammad Reza MR Mohraz Minoo M Bahramali Golnaz G Aghakhani Arezoo A Banifazl Mohammad M Foroughi Maryam M Ahmadi Farrokhlagha F Eslamifar Ali A Sadat Seyed Mehdi SM Ramezani Amitis A

Hepatitis monthly 20130511 5

<h4>Background</h4>Hepatitis D virus (HDV) is a defective virus dependent on hepatitis B virus (HBV) for its replication. Due to HDV transmission routes, patients undergoing hemodialysis and those with HIV infection are at risk of acquiring HDV.<h4>Objectives</h4>This study was aimed to determine the frequency and genotype of HDV infection among patients with HIV infection and those undergoing hemodialysis.<h4>Patients and methods</h4>720 cases including 120 patients undergoing hemodialysis, and ...[more]

PMID: 23914228

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Project description:BackgroundPatients on hemodialysis are at high risk for hepatitis C virus (HCV) infection if measures for effective control of HCV infection in the hemodialysis environment are not implemented. Whereas in developed countries isolated small-scale outbreaks of HCV in hemodialysis units are occasionally reported, HCV transmission in the hemodialysis environment still represents a substantial problem in low-resource countries. This study systematically assessed the prevalence of HCV infection among all patients at all hemodialysis centers in Kosovo, determined the HCV genotype distribution, and reviewed the main risk factors associated with HCV infection in this group of patients.MethodsFrom January to March 2013, blood samples from all patients undergoing hemodialysis at all seven hemodialysis centers in Kosovo were collected. The samples were screened for the presence of anti-HCV antibodies, and seropositive samples were also tested for HCV RNA. Genotyping was performed by sequencing the core region of the HCV genome. Subsequently, face-to-face interviews were conducted with consented patients attending hemodialysis in December 2015 and with the management of all hemodialysis centers in Kosovo.ResultsThe overall seroprevalence of HCV infection among hemodialysis patients in Kosovo was 53.0% (354/668), ranging from 22.3 to 91.1% at different centers. HCV RNA was detected in 323/354 (91.2%) seropositive patients. The most frequent HCV genotype was genotype 1a (62.2%), followed by genotypes 4d (33.1%), 1b (4.0%), and 2c (0.7%). The duration of hemodialysis and receiving dialysis at more than one center were identified as independent significant predictors of anti-HCV positivity. Shortage of staff, lack of resources, and inconsistent use of hygienic precautions and/or isolation strategies were observed.ConclusionsThe prevalence of HCV infection among hemodialysis patients in Kosovo is extremely high. The relatively low prevalence of HCV infection in the general population, predominance of two otherwise rare HCV genotypes among hemodialysis patients, and longer history of hemodialysis as a predictor of HCV infection all indicate nosocomial transmission due to inappropriate infection control practices as the main transmission route.

Dataset Information

Frequency and Genotype of Hepatitis D Virus Infection in Patients Infected with HIV and Those Undergoing Hemodialysis.

Publications

Frequency and Genotype of Hepatitis D Virus Infection in Patients Infected with HIV and Those Undergoing Hemodialysis.

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