Epidemiology

Older hemodialysis patients at greater risk of hepatitis C

Last Updated: 2004-03-26 16:21:14 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Middle-aged and elderly hemodialysis patients face significantly higher annual rates of seroconversion to hepatitis C virus (HCV) than do younger hemodialysis patients, Saudi Arabian researchers report in the February issue of the Journal of the American Geriatrics Society.

As lead investigator Dr. Anil K. Saxena from King Fahad Hospital and Tertiary Care Center, Hofuf, told Reuters Health, this study is the first "to highlight the fact that middle-aged and elderly patients on hemodialysis may be more vulnerable to acquisition of HCV infection."

Dr. Saxena and Dr. Bodh R. Panhotra explored the relationship between advancing age and the risk of acquiring HCV infection in 198 patients with end-stage renal disease enrolled for long-term hemodialysis at their facility between 1995 and 2000. Eighty-six were aged 45 to 64 years, and 62 were aged 65 and older.

Overall, 43.4% of patients were anti-HCV positive. Anti-HCV positivity was not associated with the number of units of blood transfused or the surgical interventions and invasive procedures in the preceding 6 months. Furthermore, anti-HCV positivity was significantly higher with longer hemodialysis duration.

The highest annual HCV seroconversion rates occurred in patients aged 55 to 64 (11.0%), the researchers note, followed by patients aged 65 to 74 (9.7%) and patients aged 45 to 54 (9.7%). The lowest seroconversion rate (2.5%) was seen in those aged 15 to 24.

Interestingly, the report indicates, these higher seroconversion rates occurred despite shorter durations of hemodialysis in the older age groups.

"Higher HCV prevalence and seroconversion rates with considerably shorter dialysis periods could be an expression of the greater vulnerability of middle-aged and elderly patients to HCV infection than for younger age groups," the investigators note.

It is important "to be aware that this group of patient is vulnerable to HCV infection," Dr. Saxena continued, and the researchers conclude that among measures that may be helpful are "the rigorous application of universal precautions as recommended by the CDC."

J Am Geriatr Soc 2004;52:242-46.