Frequencies of hepatitis B and C infections among haemodialysis and peritoneal dialysis patients in Asia-Pacific countries: analysis of registry data.
BACKGROUND
The impact of dialysis modality on the rates and types of infectious complications has not been well studied. The aim of the present investigation was to evaluate the rates of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections in peritoneal dialysis (PD) and haemodialysis (HD) patients in the Asia-Pacific region.


METHODS
The study included the most recent period-prevalent data recorded in the national or regional dialysis registries of the 10 Asia-Pacific countries/areas (Australia, New Zealand, Japan, China, Taiwan, Korea, Thailand, Hong Kong, Malaysia and India), where such data were available. Longitudinal data were also available for all incident Australian and New Zealand patients commencing dialysis between 1 April 1995 and 31 December 2005. Rates of HCV and HBV infections were compared by chi-square, Poisson regression and Kaplan-Meier survival analyses, as appropriate.


RESULTS
Data were obtained on 201,590 patients (HD 173,788; PD 27,802). HCV seroprevalences ranged between 0.7% and 18.1% across different countries and were generally higher in HD versus PD populations (7.9% +/- 5.5% versus 3.0% +/- 2.0%, P = 0.01). Seroconversion rates on dialysis were also significantly higher in HD patients (incidence rate ratio PD versus HD 0.33, 95% CI 0.13-0.75). HCV infection was highly predictive of mortality in Japan (relative risk 1.37, 95% CI 1.15-1.62, P = 0.003) and in Australia and New Zealand (adjusted hazards ratio 1.29, 95% CI 1.05-1.58). HBV infection data were limited, but less clearly influenced by dialysis modality.


CONCLUSIONS
Dialysis modality selection significantly influences the risk of HCV infection experienced by end-stage renal failure patients in the Asia-Pacific region. No such association could be identified for HBV infection.
Johnson
David W
DW
Australia and New Zealand Dialysis and Transplant Registry, Discipline of Public Health, University of Adelaide, Adelaide, Australia. david_johnson@health.qld.gov.au
Dent
Hannah
H
Yao
Qiang
Q
Tranaeus
Anders
A
Huang
Chiu-Chin
CC
Han
Dae-Suk
DS
Jha
Vivekanand
V
Wang
Tao
T
Kawaguchi
Yoshindo
Y
Qian
Jiaqi
J
D001315:Australia / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000628:therapy*; D007723:Korea / Q000453:epidemiology; D008296:Malaysia / Q000453:epidemiology; D009520:New Zealand / Q000453:epidemiology; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D015995:Prevalence; D012042:Registries; D012044:Regression Analysis; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology