High prevalence of hepatitis C infection among Brazilian hemodialysis patients in Rio de Janeiro: a one-year follow-up study

Vanderborght, B. O. M.; Rouzere, C.; Ginuino, C. F.; Maertens, G.; Van Heuverswyn, H.; Yoshida, C. F. T.

doi:10.1590/S0036-46651995000100012

Abstracts

Nearly 400 hemodialysis patients treated at 5 different hemodialysis units in Rio de Janeiro were tested for one year for the presence of hepatitis C and B markers. During the same period, samples were also obtained from 35 continuous ambulatory peritoneal dialysis (CAPD) patients and from 242 health care workers. Depending on the hemodialysis unit studied, anti-HCV prevalence rates ranging from 47% to 82% (mean 65%) were detected. CAPD patients showed a lower prevalence of 17%. The prevalence of antibodies against hepatitis C virus (anti-HCV) among health care workers was 2.9%. We observed a hepatitis C attack rate of 11.5% per year in the anti-HCV-negative hemodialysis patient population. An average of 9.4% of the hemodialysis patients were chronic carriers of hepatitis B virus (HBV) (range 1.8% - 20.4%), while 48.9% showed markers of previous HBV infection. The HBV attack rate was 4.5% per year (range 0% - 6%). These results indicate an alarming high prevalence of anti-HCV among hemodialysis patients of this studied region.

Hemodialysis; CAPD; Hepatitis C virus; Hepatitis B virus; Hepatitis C transmission; Brazil

Aproximadamente 400 pacientes de hemodiálise tratados em 5 diferentes unidades no Rio de Janeiro foram acompanhados durante 1 ano para presença de marcadores virais de hepatite B e C. Durante o mesmo período, amostras foram também de 35 pacientes ambulatoriais de diálise peritonial contínua (CAPD) e de 242 funcionários das unidades. Dependendo da unidade em estudo foram detectadas prevalências de anti-HCV variando de 47% a 82% (média 65%). Pacientes de CAPD demonstraram uma baixa prevalência de 17%. A prevalência de anti-HCV em funcionários foi de 2.9%. Observamos uma taxa de ataque de hepatite C de 11.5% por ano na população paciente de hemodiálise anti-HCV-negativo. Uma média de 9.4% de pacientes de hemodiálise eram portadores crônicos do vírus da hepatite B (VHB) (taxa de 1.8% a 20.4%), enquanto 48.9% apresentaram marcadores de infecção passada de HBV. A taxa de ataque de HBV foi de 4.5% por ano (taxa de 0% a 6%). Esses resultados indicam uma alarmante prevalência alta de anti-HCV em pacientes de hemodiálise dessa região estudada.

EPIDEMIOLOGY

High prevalence of hepatitis C infection among Brazilian hemodialysis patients in Rio de Janeiro: a one-year follow-up study

Alta prevalência de infecção pelo virus da hepatite C em pacientes de hemodiálise do Rio de Janeiro: estudo de acompanhamento durante 1 ano

B. O. M. Vanderborght^I,II; C. Rouzere^I,II; C. F. Ginuino^II; G. Maertens^I; H. Van Heuverswyn^I; C. F. T. Yoshida^II

^IInnogenetics N.V., Ghent, Belgium

^IIDepartment of Virology, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil

^{Correspondence to} Correspondence to: B. Vanderborght Fundação Oswaldo Cruz, Dep. de Virologia Av. Brasil 4365 21040-360 Rio de Janeiro, RJ, Brasil Phone and Fax:+ 55 21 270 63 97

SUMMARY

Nearly 400 hemodialysis patients treated at 5 different hemodialysis units in Rio de Janeiro were tested for one year for the presence of hepatitis C and B markers. During the same period, samples were also obtained from 35 continuous ambulatory peritoneal dialysis (CAPD) patients and from 242 health care workers. Depending on the hemodialysis unit studied, anti-HCV prevalence rates ranging from 47% to 82% (mean 65%) were detected. CAPD patients showed a lower prevalence of 17%. The prevalence of antibodies against hepatitis C virus (anti-HCV) among health care workers was 2.9%. We observed a hepatitis C attack rate of 11.5% per year in the anti-HCV-negative hemodialysis patient population. An average of 9.4% of the hemodialysis patients were chronic carriers of hepatitis B virus (HBV) (range 1.8% - 20.4%), while 48.9% showed markers of previous HBV infection. The HBV attack rate was 4.5% per year (range 0% - 6%). These results indicate an alarming high prevalence of anti-HCV among hemodialysis patients of this studied region.

Keywords: Hemodialysis; CAPD, Health care workers; Hepatitis C virus; Hepatitis B virus; Hepatitis C transmission; Brazil.

RESUMO

Aproximadamente 400 pacientes de hemodiálise tratados em 5 diferentes unidades no Rio de Janeiro foram acompanhados durante 1 ano para presença de marcadores virais de hepatite B e C. Durante o mesmo período, amostras foram também de 35 pacientes ambulatoriais de diálise peritonial contínua (CAPD) e de 242 funcionários das unidades. Dependendo da unidade em estudo foram detectadas prevalências de anti-HCV variando de 47% a 82% (média 65%). Pacientes de CAPD demonstraram uma baixa prevalência de 17%. A prevalência de anti-HCV em funcionários foi de 2.9%. Observamos uma taxa de ataque de hepatite C de 11.5% por ano na população paciente de hemodiálise anti-HCV-negativo. Uma média de 9.4% de pacientes de hemodiálise eram portadores crônicos do vírus da hepatite B (VHB) (taxa de 1.8% a 20.4%), enquanto 48.9% apresentaram marcadores de infecção passada de HBV. A taxa de ataque de HBV foi de 4.5% por ano (taxa de 0% a 6%). Esses resultados indicam uma alarmante prevalência alta de anti-HCV em pacientes de hemodiálise dessa região estudada.

Full text available only in PDF format.

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ACKNOWLEDGEMENTS

The authors thank Lucy Dalva de Almeida and Felipe Loponte Saback for their excellent technical assistance, and Fred Shapiro for manuscript editing.

Recebido para publicação em 06/05/1994.

Aceito para publicação em 25/08/1994.

1. ALTER, M.J.; HADLER, S.C.; JUDSON, F.N. et al. - Risk factors for acute non-A, non-B hepatitis in the United States and association with hepatitis C virus infection. J. Amer. med. Ass., 264: 2231-2235, 1990.
2. ARIMA, T.; TAKAMIZAWA, A.; MORI, C. et al. - A lambda gt11-cDNA clone specific for chronic hepatitis V generated from pooled serum presumably infected by hepatitis C virus. Gastroent. jap., 24: 545-548, 1989.
3. CHIARAMONTE, M.; STROFFOLINI, T.; CAPORASO, N. et al. - Hepatitis-C virus infection in Italy: a multicentric Seroepidemiological study (a report from the HCV study group of the Italian Association for the Study of the Liver). Ital. J. Gastroent., 23: 555-558, 1991.
4. CHOOM, Q.L.; KUO, G.; WEINER, A.J. et al. - Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science, 244: 359-362, 1989.
5. DA PORTO, A.; ADAMI, A.; SUSANNA, F. et al. - Hepatitis C virus in dialysis units: a multicenter study. Nephron, 61: 309-310, 1992.
6. FUJIYAMA, S.; KAWANO, S.; SATO, S. et al. - The prevalence of anti-HCV antibodies in hemodialysis patients. Gastroent. jap., 26 (suppl. 3): 206-208, 1991.
7. HAYASHI, J.; NAKASHIMA, K.; KAJIYAMA, W. et al. - Prevalence of antibody to hepatitis C virus in hemodialysis patients. Amer. J. Epidem., 134: 651-657, 1991.
8. JEFFERS, L.J.; PEREZ, G.O.; de MEDINA, M.D. et al. - Hepatitis C infection in two urban hemodialysis units. Kidney Int., 38: 320-322, 1990.
9. KIYOSIMA, K.; TANAKA, E.; SODEYAMA, T. et al. - Transition of antibody to hepatitis C virus from chronic hepatitis to hepatocellular carcinoma. Jap. J. Cancer. Res., 81: 1089-1091, 1990.
10. NOGUEIRA, R.M.R.; MIAGOSTOVICH, M.P.; LAMPE, E. & SCHATZMAYR, H.G. - Isolation of dengue virus type 2 in Rio de Janeiro. Mem. Inst. Oswaldo Cruz, 85: 253, 1990.
11. PARK, Y.M.; KIM, I.S.; LEE, C.D. & KIM, B.S. - Seroprevalence of antibody against hepatitis C virus (anti-HCV) in various groups of individuals in Korea. Gastroent. jap., 26 (suppl. 3): 159-163, 1991.
12. SCHLIPKOTER, U.; GLADZIWA, U.; CHOLMAKOV, K. et al. - Prevalence of hepatitis C virus infections in dialysis patients and their contacts using a second generation enzyme-linked immunosorbent assay. Med. Microbiol. Immunol., 181: 173-180, 1992.
13. SHEU, J.C.; LEE, S.H.; WANG, J.T. et al. - Prevalence of anti-HCV and HCV viremia in hemodialysis patients in Taiwan. J. med. Virol., 37: 108-112, 1992.
14. STUYVER, L.; ROSSAU, R.; WYSEUR, A. et al. - Typing of hepatitis C virus (HCV) isolates and characterization of new (sub)types using a line Probe Assay. J. gen. Virol., 74: 1093-1102, 1993.
15. VANDELLI, L.; MEDICI, G.; SAVAZZI, A.M. et al. - Behaviour of antibody profile against hepatitis C virus in patients on maintenance hemodialysis. Nephron, 61: 260-262, 1992.
16. VANDERBORGHT, B.O.M.; REIS, A.M.M.; ROUZERE, C. et al. - Prevalence of anti-hepatitis C virus in the blood donor population of Rio de Janeiro. Vox Sang. (Basel), 65: 122-125, 1993.
17. VAN DER POEL, C.L.; REESINK, H.W.; MAUSER BUNSCHOTEN, E.P. et al. - Prevalence of anti-HCV antibodies confirmed by recombinant immunoblot in different population subsets in The Netherlands. Vox Sang. (Basel), 61: 30-36, 1991.
18. YOSHIDA, C.F.T.; ROUZERE, C.D.; NOGUEIRA, R.M.R. et al. - Human antibodies to dengue and yellow fever do not react in diagnostic assay for hepatitis C virus. Braz. J. med. biol. Res., 25: 1131-1135, 1992.
19. YOSHIDA, C.F.T.; SOARES, O.A.; SCHATZMAYR, H.G.; UY, A. & GERLICH, W.H. - Early appearance and biphasic kinetics of IgG antibody against hepatitis C virus protein C100-3. Med. Microbiol. Immunol., 180: 279-287, 1992.
20. YOSHIDA, C.F.T.; TAKAHASHI, Y.; VANDERBORGHT, B.O.M. et al. - Antibodies against non-structural c100/3 and structural core antigen of hepatitis C virus (HCV) in hemodialysis patients. Rev. Inst. Med. trop. S. Paulo, 35: 315-321, 1993.

Correspondence to:

B. Vanderborght

Fundação Oswaldo Cruz, Dep. de Virologia

Av. Brasil 4365

21040-360 Rio de Janeiro, RJ, Brasil

Phone and Fax:+ 55 21 270 63 97

Publication Dates

Publication in this collection
22 Feb 2007
Date of issue
Feb 1995

History

Accepted
25 Aug 1994
Received
06 May 1994

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ALTER, M.J.; HADLER, S.C.; JUDSON, F.N. et al. - Risk factors for acute non-A, non-B hepatitis in the United States and association with hepatitis C virus infection. J. Amer. med. Ass., 264: 2231-2235, 1990.

[2] 2. ARIMA, T.; TAKAMIZAWA, A.; MORI, C. et al. - A lambda gt11-cDNA clone specific for chronic hepatitis V generated from pooled serum presumably infected by hepatitis C virus. Gastroent. jap., 24: 545-548, 1989.

[3] 3. CHIARAMONTE, M.; STROFFOLINI, T.; CAPORASO, N. et al. - Hepatitis-C virus infection in Italy: a multicentric Seroepidemiological study (a report from the HCV study group of the Italian Association for the Study of the Liver). Ital. J. Gastroent., 23: 555-558, 1991.

[4] 4. CHOOM, Q.L.; KUO, G.; WEINER, A.J. et al. - Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome. Science, 244: 359-362, 1989.

[5] 5. DA PORTO, A.; ADAMI, A.; SUSANNA, F. et al. - Hepatitis C virus in dialysis units: a multicenter study. Nephron, 61: 309-310, 1992.

[6] 6. FUJIYAMA, S.; KAWANO, S.; SATO, S. et al. - The prevalence of anti-HCV antibodies in hemodialysis patients. Gastroent. jap., 26 (suppl. 3): 206-208, 1991.

[7] 7. HAYASHI, J.; NAKASHIMA, K.; KAJIYAMA, W. et al. - Prevalence of antibody to hepatitis C virus in hemodialysis patients. Amer. J. Epidem., 134: 651-657, 1991.

[8] 8. JEFFERS, L.J.; PEREZ, G.O.; de MEDINA, M.D. et al. - Hepatitis C infection in two urban hemodialysis units. Kidney Int., 38: 320-322, 1990.

[9] 9. KIYOSIMA, K.; TANAKA, E.; SODEYAMA, T. et al. - Transition of antibody to hepatitis C virus from chronic hepatitis to hepatocellular carcinoma. Jap. J. Cancer. Res., 81: 1089-1091, 1990.

[10] 10. NOGUEIRA, R.M.R.; MIAGOSTOVICH, M.P.; LAMPE, E. & SCHATZMAYR, H.G. - Isolation of dengue virus type 2 in Rio de Janeiro. Mem. Inst. Oswaldo Cruz, 85: 253, 1990.

[11] 11. PARK, Y.M.; KIM, I.S.; LEE, C.D. & KIM, B.S. - Seroprevalence of antibody against hepatitis C virus (anti-HCV) in various groups of individuals in Korea. Gastroent. jap., 26 (suppl. 3): 159-163, 1991.

[12] 12. SCHLIPKOTER, U.; GLADZIWA, U.; CHOLMAKOV, K. et al. - Prevalence of hepatitis C virus infections in dialysis patients and their contacts using a second generation enzyme-linked immunosorbent assay. Med. Microbiol. Immunol., 181: 173-180, 1992.

[13] 13. SHEU, J.C.; LEE, S.H.; WANG, J.T. et al. - Prevalence of anti-HCV and HCV viremia in hemodialysis patients in Taiwan. J. med. Virol., 37: 108-112, 1992.

[14] 14. STUYVER, L.; ROSSAU, R.; WYSEUR, A. et al. - Typing of hepatitis C virus (HCV) isolates and characterization of new (sub)types using a line Probe Assay. J. gen. Virol., 74: 1093-1102, 1993.

[15] 15. VANDELLI, L.; MEDICI, G.; SAVAZZI, A.M. et al. - Behaviour of antibody profile against hepatitis C virus in patients on maintenance hemodialysis. Nephron, 61: 260-262, 1992.

[16] 16. VANDERBORGHT, B.O.M.; REIS, A.M.M.; ROUZERE, C. et al. - Prevalence of anti-hepatitis C virus in the blood donor population of Rio de Janeiro. Vox Sang. (Basel), 65: 122-125, 1993.

[17] 17. VAN DER POEL, C.L.; REESINK, H.W.; MAUSER BUNSCHOTEN, E.P. et al. - Prevalence of anti-HCV antibodies confirmed by recombinant immunoblot in different population subsets in The Netherlands. Vox Sang. (Basel), 61: 30-36, 1991.

[18] 18. YOSHIDA, C.F.T.; ROUZERE, C.D.; NOGUEIRA, R.M.R. et al. - Human antibodies to dengue and yellow fever do not react in diagnostic assay for hepatitis C virus. Braz. J. med. biol. Res., 25: 1131-1135, 1992.

[19] 19. YOSHIDA, C.F.T.; SOARES, O.A.; SCHATZMAYR, H.G.; UY, A. & GERLICH, W.H. - Early appearance and biphasic kinetics of IgG antibody against hepatitis C virus protein C100-3. Med. Microbiol. Immunol., 180: 279-287, 1992.

[20] 20. YOSHIDA, C.F.T.; TAKAHASHI, Y.; VANDERBORGHT, B.O.M. et al. - Antibodies against non-structural c100/3 and structural core antigen of hepatitis C virus (HCV) in hemodialysis patients. Rev. Inst. Med. trop. S. Paulo, 35: 315-321, 1993.