Chronic Haemodialysis Linked To Hepatitis E In Saudi Arabia

Patients in Saudi Arabia undergoing chronic haemodialysis are more likely to be infected with Hepatitis E virus (HEV) than both healthy controls and other patients.

HEV is endemic in Saudi Arabia so researchers from King Fahd Central Hospital Gizan, determined the prevalence of antibody against HEV in 83 subjects undergoing chronic haemodialysis, 400 healthy controls matched for age and sex, 64 outpatients and 113 inpatients.

They reported that 4.8 percent of patients undergoing chronic haemodialysis were IgM anti-HEV positive. This compared to 0.3 percent among healthy controls, equivalent to an odds ratio of 20.2 between the two groups. However, there was no significant difference in the prevalence of IgG anti-HEV in haemodialysis patients compared to controls.

Among outpatients, 1.6 percent were IgM anti-HEV positive. No in-patient expressed IgM against HEV. Therefore, the odds ratio for being IgM anti-HEV positive in the haemodialysis subjects was 8.9 compared to outpatients and inpatients combined.

Patients could have contracted HEV in the haemodialysis unit but the authors believe that a community source is more probable. They note, for example, that the prevalence in the haemodialysis group was not significantly different to that in outpatients: 4.8 and 1.6 percent respectively.

No subject expressed IgM against hepatitis A virus (HAV). Moreover, the prevalence of IgG anti-HAV was similar in haemodialysis subjects, healthy controls and the non-haemodialysis patients: 72.3, 74.3 and 75.7 percent respectively.

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