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Abstract: SA-PO449

The World Prevalence, Associated Risk Factors, and Mortality of Hepatitis C Virus Infection in Hemodialysis Patients: A Meta-Analysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Lertussavavivat, Tanat, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand
  • Greeviroj, Primploy, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand
  • Thongsricome, Thana, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand
  • Takkavatakarn, Kullaya, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand
  • Phannajit, Jeerath, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand
  • Avihingsanon, Yingyos, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand
  • Praditpornsilpa, Kearkiat, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand
  • Eiam-Ong, Somchai, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand
  • Susantitaphong, Paweena, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand
Background

Hemodialysis patients constitute high-risk population for HCV infection. The world burden of HCV infection among hemodialysis patients has not been systematically examined.

Methods

A systematic literature search was conducted in MEDLINE and Scopus to determine the world prevalence of HCV infection, risk factors, and outcomes among hemodialysis patients. Random-effect models and meta-regressions were used to generate pooled estimates and assess heterogeneity.

Results

Four hundred and seven studies with 1,302,167 participants were analyzed. The pooled prevalence of HCV infection was 21%. The highest prevalence was observed in Africa (28%) and low-income countries (48.5%). A significant prevalence was declined following the publication year and was also inversely related to GDP spent on total health expenditure and total population of each country. The most common HCV genotype was genotype 1b (33.5%), followed by genotype 1a (22.8%), 3 (8.2%), 2 (6%), 4 (5%), and 6 (2.4%). Factors associated with HCV positivity included younger age, longer dialysis duration, more blood transfusions, and dialyzer reuse. The pooled unadjusted HR for all-cause mortality was 1.12 (95%CI 1.03 to 1.22), and the adjusted HR was 1.21 (95%CI 1.12 to 1.30) in HCV-infected relative to non-HCV infected patients. There was significantly higher HCV-associated mortality from infection and malignancy.

Conclusion

HCV infection among hemodialysis patients is a shared burden worldwide and is associated with a higher risk of death.

Pooled prevalence of HCV infection among hemodialysis patients (A) by world zones and HCV genotype distribution (B) by regions and (C) country’s income