Seroepidemiology of hepatitis E in patients on haemodialysis in Croatia

Purpose Data on the seroprevalence of hepatitis E virus (HEV) in heamodialysis (HD) patients are conflicting, ranging from 0 to 44%. The aim of this study was to determine the HEV seroprevalence and risk factors among HD patients in Croatia. Methods A total of 394 HD patients from six medical facili...

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Bibliographic Details
Published in:International urology and nephrology 2020-02, Vol.52 (2), p.371-378
Main Authors: Mrzljak, Anna, Dinjar-Kujundzic, Petra, Knotek, Mladen, Kudumija, Boris, Ilic, Mario, Gulin, Marijana, Zibar, Lada, Hrstic, Irena, Jurekovic, Zeljka, Kolaric, Branko, Jemersic, Lorena, Prpic, Jelena, Tomljenovic, Morana, Vilibic-Cavlek, Tatjana
Format: Article
Language:English
Subjects:
Blood transfusion
Blood Transfusion - statistics & numerical data
Coastal zone
Croatia - epidemiology
Enzyme-linked immunosorbent assay
Female
Hemodialysis
Hepatitis
Hepatitis Antibodies - blood
Hepatitis E - epidemiology
Hepatitis E - immunology
Hepatitis E virus - genetics
Humans
Immunoglobulin G
Immunoglobulin G - blood
Immunoglobulin M
Immunoglobulin M - blood
Immunoglobulins
Kidney Failure, Chronic - epidemiology
Kidney Failure, Chronic - therapy
Male
Medicine
Medicine & Public Health
Middle Aged
Nephrology
Nephrology - Original Paper
Polymerase chain reaction
Renal Dialysis - methods
Renal Dialysis - statistics & numerical data
Residence Characteristics - statistics & numerical data
Ribonucleic acid
Risk Factors
RNA
RNA, Viral - isolation & purification
Seroepidemiologic Studies
Seroepidemiology
Urology
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Summary:Purpose Data on the seroprevalence of hepatitis E virus (HEV) in heamodialysis (HD) patients are conflicting, ranging from 0 to 44%. The aim of this study was to determine the HEV seroprevalence and risk factors among HD patients in Croatia. Methods A total of 394 HD patients from six medical facilities in five Croatian cities (three sites in the continental and three sites in the coastal region) were tested for HEV IgM/IgG antibodies using an enzyme-linked immunosorbent assay. Additionally, all samples were tested for HEV RNA by RT-PCR. Sociodemographic data and risk factors were collected using a questionnaire. Results HEV IgG antibodies were detected in 110 (27.9%) patients. The seroprevalence varied significantly between dialysis centres, ranging from 5.2 to 43.4% ( p  = 0.001). HEV IgM antibodies were found in 0.04% of IgG positive patients. All patients tested negative for HEV RNA. Factors associated with HEV IgG seropositivity were age > 60 years (OR 8.17; 95% CI 1.08–62.14), living in the continental parts of the country (OR 2.58; 95% CI 1.55–4.30), and transfusion of blood products (OR 1.66; 95% CI 1.01–2.73). After adjusting for age and gender, patients from continental regions had higher odds of HEV seropositivity compared to patients from coastal regions (OR 2.88; 95% CI 1.71–4.85) and those who had RBC transfusions (OR 1.70, 95% CI 1.02–2.69) compared to those who did not. Conclusion The study showed a high HEV seropositivity among HD patients in Croatia, with significant variations between geographical regions. Continental area of residence and RBC transfusion were the most significant risk factors for HEV seropositivity. Due to the high seroprevalence, routine HEV screening among HD patients, especially in transplant candidates should be considered.
ISSN:0301-1623
1573-2584
DOI:10.1007/s11255-019-02363-3