Hepatitis B virus 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 B virus (HBV) infection in maintenance hemodialysis (HD) patients in China and help to inform prevention programs and guide future research.


METHODS
A systematic review was constructed based on the computerized literature database. Confidence intervals (95% CI) of infection rates were calculated using the approximate normal distribution model. Odds ratios (OR) and 95% CI were calculated by fixed or random effects models. Hepatitis B surface antigen positivity (HBsAg (+)) was set as the sign of HBV infection.


RESULTS
Fifty studies met our inclusion criteria. The pooled prevalence of HBV infection among HD patients in China was 11.9%. Blood transfusion was correlated with an increase in HBV infection (p = 0.05). HD patients with a long-term history were more likely to be infected than those with a short-term history. The levels of alanine aminotransferase were higher in the HBsAg (+) patients (p < 0.001). Large doses of HBV vaccine (80 μg/dose) increased the seroconversion rate. The response rate of intradermal injection of HBV vaccine was higher than that of intramuscular injection.


CONCLUSIONS
Hepatitis B is still one of the main complications in HD patients in China, and the frequency of blood transfusion and duration of HD were the risk factors. Large doses and intradermal injection of HBV vaccine were recommended to prevent HBV infection in HD patients. The findings of this meta-analysis have implications for optimal prevention and treatment of Hepatitis B in HD patients.
Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Cuiyu
C
Wang
Jinghua
J
Sun
Bei
B
Zhu
Steven
S
Larsen
Rongbin
R
Yu
Jianqing
J
Wu
Weihong
W
Zhao
D002681:China / Q000453:epidemiology; D015897:Comorbidity; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D007271:Injections, Intradermal; D007273:Injections, Intramuscular; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D013997:Time Factors; D065227:Transfusion Reaction
D017325:Hepatitis B Vaccines