Hepatitis C infection and related factors in hemodialysis patients in china: systematic review and meta-analysis.
OBJECTIVE
To provide a comprehensive and reliable tabulation of available data on the epidemiological characteristics and risk factors for hepatitis C virus (HCV) infection in maintenance hemodialysis (HD) patients in China, and to help inform prevention programs and guide future research.


METHODS
A systematic review was constructed based on the computerized literature database by two reviewers independently. Ninety-five percent confidence intervals (CI) of infection rates were calculated using the approximate normal distribution model. Odds ratios and 95% CI were calculated by fixed or random effects models.


RESULTS
Forty-three studies met our inclusion criteria. The pooled prevalence of HCV infection among HD patients in China was 41.1% (95% CI 39.5-42.6%). No significant difference was found in HCV infection rates between male and female HD patients (OR = 0.75, 95% CI 0.52-1.07, p = 0.11). HD patients with blood transfusion were 5.65 times more likely to be infected with HCV than HD patients without blood transfusion. A longer duration of HD was associated with increased HCV prevalence. Co-infection with hepatitis B virus did not increase the probability of HCV infection among HD patients (OR = 1.19, 95% CI 0.34-3.20, p = 0.73).


CONCLUSIONS
Viral hepatitis is still one of the main complications in HD patients, with hepatitis C being the most common one. The key to reducing the incidence of viral hepatitis in HD patients is to control contagion and reduce the frequency of blood transfusion and cross-infection.
Sun
Jinghua
J
Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
Yu
Rongbin
R
Zhu
Bei
B
Wu
Jianqing
J
Larsen
Steven
S
Zhao
Weihong
W
D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000453:epidemiology; D016019:Survival Analysis; D065227:Transfusion Reaction