Prevalence and associated factors of hepatitis B and C virus in hemodialysis patients in Africa

Background Due to its invasive procedure patients on hemodialysis (HD) are
at high risk of infections. Infections acquired in dialysis units can
prolong hospitalization date and/or prolong illness in patients, and
increase treatment cost. There are no adequate data on the prevalence of
Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections in HD
patients. Therefore, this study aimed to estimate the pooled prevalence
and associated factors of HBV and HCV infections among HD patients in
Africa. Method The databases PubMed, Medline, EMBASE, Cochrane library,
web of science, African Journals Online, Science Direct, and Google
Scholar were searched to identify relevant studies. The review was
performed based on Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA) guidelines. Data were extracted independently by
two authors and analyzed using STATA 11. A random-effect model was fitted
to estimate the pooled prevalence with their 95% confidence interval. To
detect publication bias funnel plots analysis and Egger weighted
regression tests were done. Results The overall pooled prevalence of HBV
and HCV infection among HD patients in Africa was 9.88% (95% CI:
7.20-12.56) I2=97.9% and 23.04% (95% CI: 18.51-2757) I2=99.6%,
respectively. In addition, the pooled prevalence of HBV and HCV
co-infection was 7.18% (95% CI: 3.15-11.20) I2=99.6%. Duration of dialysis
was found to be the contributing factor for the occurrence of HBV and HCV
among HD patients (OR=1.44; 95% CI: 1.04, 2.01). Conclusion This study
showed that there is high prevalence of HBV and HCV infections in HD
patients in Africa. Therefore, strict adherence to precautions of
infection control measures, isolation of seropositive patients,
improvement in infrastructures, adequate screening of HBV and HCV for the
donated blood, and decentralized HD services is needed to minimize the
risk of HBV and HCV infections in HD facilities.