The vulnerability of middle-aged and elderly patients to hepatitis C virus infection in a high-prevalence hospital-based hemodialysis setting.
OBJECTIVE
To determine the relationship between advancing age and the risk of acquiring hepatitis C virus (HCV) infection, through evaluation and statistical comparison of seroprevalence and seroconversion rates in different age groups of patients on long-term hemodialysis (HD).


METHODS
Retrospective cohort study.


METHODS
Hemodialysis facility of King Fahad Hospital and Tertiary Care Center, Al-Hasa region of the eastern province of Saudi Arabia.


METHODS
One hundred ninety-eight patients with end-stage renal disease enrolled for long-term HD therapy from September 1995 to September 2000.


METHODS
HCV seroprevalence and seroconversion rates.


RESULTS
The overall HCV seroprevalence of 43.4% (86/198) and seroconversion rate of 8.6% per year were recorded. Patients aged 55 to 64 had the highest anti-HCV prevalence (55.3% (26/47)) and annual seroconversion rates (11.0%). Those aged 65 to 74 had the next-highest prevalence (48.9% (24/49)) and seroconversion rate (9.7%), and patients aged 15 to 24 had the lowest prevalence (12.5% (1/8)) and seroconversion rate (2.5%) (reference group).


CONCLUSIONS
Significantly higher annual seroconversion rates in those aged 55 to 64 and 65 to 74 during a shorter dialysis period (35.6 and 32.7 vs 58.0 months), suggest the greater susceptibility of the middle-aged and elderly patients to acquisition of HCV infection than the younger (15-24 years) group. This could be attributed to the combined effect of immunosuppression associated with advancing age, uremia, and undernutrition, but multicenter molecular follow-up studies with larger sample sizes would be needed to corroborate these findings and plan appropriate strategies for these high-risk groups.
Saxena
Anil K
AK
Division of Nephrology, Departments of Microbiology, King Fahad Hospital and Tertiary Care Center, Hofuf, Al-Hasa, Saudi Arabia. dranil_31982@yahoo.com
Panhotra
Bodh R
BR
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology* / Q000635:transmission* / Q000821:virology; D004198:Disease Susceptibility; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000821:virology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D017678:Sex Distribution