Hepatitis C virus infection and haemodialysis: experience of a district general hospital in Brunei Darussalam

Chong VH, Zinna HS
Correspondence: Dr Chong Vui Heng, chongvuih@yahoo.co.uk

ABSTRACT
Introduction Hepatitis C virus (HCV) infection is prevalent among patients undergoing haemodialysis (HD). This study assessed the characteristics and outcomes of HCV infections among patients undergoing regular HD in a small dialysis centre.
Methods All patients (total 71, male 52 percent) who had HD were identified from the dialysis register and retrospectively reviewed.
Results The mean age was 48.0 (+/– 14.7) years at the start of HD and the overall incidence of HCV IgG seropositivity (+) was 31 percent (22 patients). Ten patients were documented to have acquired HCV infection after starting HD, and nine cases before the institution of control measures. HCV RNA was detected in 14 of 17 (82.4 percent) patients who had RNA testing. Genotyping was done for seven patients; genotype 1a (two), genotype 1a/b (one) genotype 2b (one) and genotype 3a (three). HCV IgG (+) patients were younger, had longer duration of HD and had more transaminitis (all p-values less than 0.05) compared to HCV IgG (–) patients. Five patients had interferon treatment and three had sustained viral response (HCV RNA undetected at six months post-completion). At a mean HD duration of 54.8 (+/– 40.3) months, 25 patients (35.2 percent) died, with similar proportion from those HCV IgG (+) (31.8 percent) and those HCV IgG (–) (36.7 percent), respectively (p-value equal to 0.688). There were no difference in age (p-value equal to 0.444) and duration of HD (p-value equal to 0.534) between these two groups. None of the deaths were due to liver disease.
Conclusion HCV infection is common among patients attending HD and sharing of dialysis machines is an important factor. HCV infection was not a significant factor on the mortality in this study but longer follow-up is required.

Keywords: end-stage renal failure, genotypes, haemodialysis, hepatitis C
Singapore Med J 2008; 49(11): 916-920