Article thumbnail
Location of Repository

Hepatitis B virus infection in Haemodialysis Centres from Santa Catarina State, Southern Brazil. Predictive risk factors for infection and molecular epidemiology

By Flair J Carrilho, Cleusa R Moraes, João RR Pinho, Isabel MVGC Mello, Dennis A Bertolini, Marcílio F Lemos, Regina C Moreira, Leda C Bassit, Rita A Cardoso, Gabriela Ribeiro-dos-Santos and Luiz C Da Silva

Abstract

BACKGROUND: Patients under haemodialysis are considered at high risk to acquire hepatitis B virus (HBV) infection. Since few data are reported from Brazil, our aim was to assess the frequency and risk factors for HBV infection in haemodialysis patients from 22 Dialysis Centres from Santa Catarina State, south of Brazil. METHODS: This study includes 813 patients, 149 haemodialysis workers and 772 healthy controls matched by sex and age. Serum samples were assayed for HBV markers and viraemia was detected by nested PCR. HBV was genotyped by partial S gene sequencing. Univariate and multivariate statistical analyses with stepwise logistic regression analysis were carried out to analyse the relationship between HBV infection and the characteristics of patients and their Dialysis Units. RESULTS: Frequency of HBV infection was 10.0%, 2.7% and 2.7% among patients, haemodialysis workers and controls, respectively. Amidst patients, the most frequent HBV genotypes were A (30.6%), D (57.1%) and F (12.2%). Univariate analysis showed association between HBV infection and total time in haemodialysis, type of dialysis equipment, hygiene and sterilization of equipment, number of times reusing the dialysis lines and filters, number of patients per care-worker and current HCV infection. The logistic regression model showed that total time in haemodialysis, number of times of reusing the dialysis lines and filters, and number of patients per worker were significantly related to HBV infection. CONCLUSIONS: Frequency of HBV infection among haemodialysis patients at Santa Catarina state is very high. The most frequent HBV genotypes were A, D and F. The risk for a patient to become HBV positive increase 1.47 times each month of haemodialysis; 1.96 times if the dialysis unit reuses the lines and filters ≥ 10 times compared with haemodialysis units which reuse < 10 times; 3.42 times if the number of patients per worker is more than five. Sequence similarity among the HBV S gene from isolates of different patients pointed out to nosocomial transmission

Topics: Research Article
Publisher: BioMed Central
Year: 2004
DOI identifier: 10.1186/1471-2458-4-13
OAI identifier: oai:pubmedcentral.nih.gov:419975
Provided by: PubMed Central

Suggested articles

Citations

  1. (2000). A new genotype of hepatitis B virus: complete genome and phylogenetic relatedness.
  2. (1980). A simple method for estimating evolutionary rates of bases substitutions through comparative studies of nucleotide sequences.
  3. (1995). Ajzen H: Incidence of and risk factors for hepatitis B virus and hepatitis C virus infection among haemodialysis and CAPD patients: evidence for environmental transmission. Nephrol Dial Transplant
  4. (1991). ALMofleh IA, Abu-Aisha H: Prevalence and significance of antibodies to hepatitis C virus among Saudi haemodialysis patients.
  5. (1994). Alquezar AS: Acompanhamento dos marcadores das hepatites B e C em uma unidade de diálise [abstract]. Rev Soc Bras Med Trop
  6. (1999). Alter MJ: Hepatitis B and hemodialysis: the impact of universal precautions in preventing the transmission of bloodborne viruses. Letter to the editor. Infect Control Hosp Epidemiol
  7. (1999). Alter MJ: Preventing hepatitis B and hepatitis C virus infections in end-stage renal disease patients: back to basics. Hepatology
  8. (1996). Alter MJ: The reemergence of hepatitis B virus infection in hemodialysis centers. Sem Dialysis
  9. (1999). AM: Prevalence of serologic markers of the hepatitis B virus in hospital personnel. Rev Saúde Púb
  10. (1984). AMC: Hemodiálise e hepatite a vírus B.
  11. (1983). Anti-HCV reactivity in dialysis patients: discrepancies between first and second generation tests [letter]. Nephron
  12. (1977). AR: DNA sequencing with chainterminating inhibitors.
  13. (1987). CF: Geographic distribution of HBsAg subtypes in Brazil. Mem Inst Oswaldo Cruz
  14. (1999). CFT: Hepatitis B virus: genotypes and subtypes in Brazilian hemodialysis patients. Artif Org
  15. (1991). Cheng IKP: Hepatitis C infection Among dialysis patients: a comparison between patients on maintenance haemodialysis and continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant
  16. (1993). Chong-Ghee T: Reavaliação por testes de 2a geração da prevalência de anticorpos da Hepatite C (soro e extrato sérico de papel de filtro) em uma unidade de transplante renal. Rev Bras Pat Clín
  17. (1998). Corrêa MCJM: Magnitude of hepatitis B and C in Latin America.
  18. (1993). Detection of hepatitis C infection by polymerase chain reaction among hemodialysis patients.
  19. (1997). DG: The Clustal X windows interface: flexible strategies for multiple sequence alignment aided by quality analysis tools. Nucl Ac Res
  20. (1989). Disease Control and Prevention: Guidelines for Dialysis Centers. Dial Transplant
  21. (1973). Dismukes WE: Hemodialysis-associated hepatitis.
  22. (1995). Draibe SA: Environmental transmission of hepatitis B and hepatitis C viruses within the hemodialysis unit. Artif Org
  23. (1993). Erba G: Antibodies to hepatitis C virus and transaminase concentration in chronic haemodialysis patients: a study with second – generation assays. Nephrol Dial Transplant
  24. (1998). Estudo epidemiológico caso – controle da infecção pelo vírus da hepatite C em pacientes e funcionários das Unidades de Diálise do Estado de Santa Catarina. PhD thesis.
  25. (1976). Gregg MB: Transmission of hepatitis B associated with hemodialysis: role of malfunction (blood leaks) in dialysis machines.
  26. (1977). Hepatitis B in ward and clinical laboratory employees of a general hospital.
  27. (1995). Hepatitis C virus infection among chronic dialysis patients in the South of France: a collaborative study.
  28. (1993). High incidence of hepatitis C virus infecction in hemodialysis patients in Taiwan.
  29. Jr: Hepatite B em hemodiálise.
  30. (2001). Karayiannis P: Transmission of hepatitis B virus infection in Gambian families revealed by phylogenetic analysis.
  31. (1992). KI: High incidence of hepatitis virus antibodies in hemodialysis patients. Nephron
  32. (1999). L: Incidência dos marcadores virais para a hepatite B e resposta a vacinação em uma unidade de hemodiálise. Gastroenterol Endosc Digest
  33. (1991). Lyra L: Incidence of markers of hepatitis B and C in patients undergoing hemodialysis [abstract]. Acta Hepatol
  34. (1992). Magnius LO: Comparison of the amino acid sequences of nine different serotypes of hepatitis B surface antigen and genomic classification of the corresponding hepatitis B virus strains.
  35. (2002). Magnius LO: Genotype H: a new Amerindian genotype of hepatitis B virus revealed in Central America.
  36. (1992). Magnius LO: Molecular basis of hepatitis B virus serotype variations within the four major subtypes.
  37. (2001). Nei M: MEGA2: molecular evolutionary genetics analysis software. Bioinformatics
  38. (1986). Parande CM: Viral hepatitis markers in patients on haemodialysis in a hyperendemic area.
  39. (1994). Reuso dos dialisadores: formaldeído ou ácido peracético?
  40. (1989). RH: Rapid and sensitive method for the detection of serum hepatitis B virus DNA using the Polymerase Chain Reaction technique.
  41. (1992). S: Hepatitis virus infection (HBV and HCV) in eleven Japanese hemodialysis units. Clin Nephrol
  42. (1985). Sabbaga E: Prognóstico hepático em pacientes transplantados com HBsAg positivopré-transplante. Rev Hosp Clín Fac Med, S Paulo
  43. (1989). SAS/STAT User's guide Volume 2. 4th edition.
  44. (1991). Siamopoulos KC: Antibodies against hepatitis C virus (anti-HCV) in haemodialysis patients: association with hepatitis B serological markers. Nephrol Dial Transplant
  45. (1983). Soulier JP: Distribution of HBsAg subtypes in the World. Vox Sang
  46. (1995). Strihou CVY: Implications of chronic hepatitis B or hepatitis C infection for renal transplant candidates. Nephrol Dial Transplant
  47. (1986). Tachibana-Yoshida CF: Hepatitis B virus infection in hemodialysis units: clinical features, epidemiolgical markers and general control measures.
  48. (1970). The analysis of Binary data.
  49. (1976). The geographical distribution of HBsAg subtypes. Bibl Haemato
  50. (1988). Typing hepatitis B virus by homology in nucleotide sequence: comparison of surface antigen subtypes.

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.