RISK FACTORS FOR TRANSMISSION OF VIRAL HEPATITIS B & C IN HEMODIALYSIS PATIENT

Abstract

Background: Hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis D virus (HDV) continue to pose major global health challenges, particularly among patients undergoing hemodialysis (HD). These patients experience repeated exposure to blood products, prolonged vascular access, immunosuppression, and increased risk of cross-contamination, all of which amplify vulnerability to viral transmission. Prevalence varies significantly across regions due to disparities in healthcare infrastructure, infection control practices, and screening quality.

Objective: This review aimed to examine the prevalence, associated risk factors, and clinical implications of HBV, HCV, and HDV infections among hemodialysis patients, with added emphasis on resource-limited healthcare settings.

Methods: A descriptive, literature-based review approach was applied using peer-reviewed journals, WHO and CDC epidemiological reports, and regional surveillance databases. Studies were included if they reported numerical prevalence data for HBV, HCV, or HDV among hemodialysis patients, highlighted risk factors linked to viral transmission, or addressed public health implications in renal failure populations. Data extraction covered HBsAg, anti-HCV, and anti-HDV rates; regional variations; transfusion-related exposure; cross-contamination events; and structural limitations within dialysis units. Findings were synthesized thematically to ensure coherence across multiple healthcare contexts.

Results: Prevalence estimates varied widely across global regions, with HBV ranging from 3–42%, HCV from 5–60%, and HDV (among HBsAg-positive patients) from 0–44.5%. Risk factors consistently identified included multiple blood transfusions, long-term vascular access, immunosuppression, dialysis at multiple centers, and poor infection control compliance. In resource-limited countries such as Botswana, where kidney transplantation is rare, heavy reliance on long-term dialysis heightened the risk of viral transmission. Several studies also indicated strong evidence of nosocomial spread within HD units.

Conclusion: Viral hepatitis remains a significant contributor to morbidity and mortality in hemodialysis patients. Wide regional variation reflects differences in healthcare capacity and infection prevention systems. Strengthening HBV vaccination programs, enforcing strict infection-control protocols, and improving dialysis infrastructure—particularly in low-resource countries—are essential steps toward reducing the burden of HBV, HCV, and HDV in this high-risk population.