title: Hepatitis B and C virus infection among hemodialysis patients in Yogyakarta, Indonesia: Prevalence and molecular evidence for nosocomial transmission.
abstract: Hemodialysis patients are at an increased risk of acquiring hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. However, the prevalence of hepatitis viral infection and its genotype distribution among hemodialysis patients in Indonesia are unclear. In order to investigate these issues and the possibility of nosocomial transmission, 161 hemodialysis patients and 35 staff members at one of the hemodialysis unit in Yogyakarta, Indonesia, were tested for serological and virological markers of both viruses. HBV surface antigen (HBsAg) was detected in 18 patients (11.2%) and in two staff members (5.7%). Anti-HCV was detected in 130 patients (80.7%) but not in any staff members. Occult HBV and HCV infection were detected in 21 (14.7%) and 4 (12.9%) patients, respectively. The overall prevalence rates of HBV and HCV infection among patients were 24.2% and 83.2%, respectively. HCV infection was independently associated with hemodialysis duration and the number of blood transfusions. Phylogenetic analysis revealed that 23 of 39 tested HBV strains (59%) were genotype B, 11 (28.2%) were genotype C, and 5 (12.8%) were genotype A. HCV genotype 1a was dominant (95%) among 100 tested HCV strains. Nosocomial transmission was suspected because the genotype distribution differed from that of the general population in Indonesia, and because the viral genomes of several strains were identical. These findings suggest that HBV and HCV infection is common among hemodialysis patients in Yogyakarta, and probably occurs through nosocomial infection. Implementation of strict infection-control programs is necessary in hemodialysis units in Indonesia.
authors.affiliation: Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Hanggoro Tri
authors.initials: HT
authors.lastname: Rinonce
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yano
authors.forename: Takako
authors.initials: T
authors.lastname: Utsumi
authors.forename: Didik Setyo
authors.initials: DS
authors.lastname: Heriyanto
authors.forename: Nungki
authors.initials: N
authors.lastname: Anggorowati
authors.forename: Dewiyani Indah
authors.initials: DI
authors.lastname: Widasari
authors.forename: Maria Inge
authors.initials: MI
authors.lastname: Lusida
authors.lastname: Soetjipto
authors.forename: Heru
authors.initials: H
authors.lastname: Prasanto
authors.forename: Hak
authors.initials: H
authors.lastname: Hotta
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D003428:Cross Infection / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D004279:DNA, Viral / Q000737:chemistry / Q000235:genetics; D018562:Disease Transmission, Infectious; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006509:Hepatitis B / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D015995:Prevalence; D012367:RNA, Viral / Q000737:chemistry / Q000235:genetics; D006435:Renal Dialysis / Q000009:adverse effects*; D017422:Sequence Analysis, DNA
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D012367:RNA, Viral