Epidemiology of chronic hepatitis B and C among dialysis patients in Switzerland

Background: Among patients with renal insufficiency undergoing chronic dial ysis treatment, chronic hepatitis due to infection with viruses of the hepa titis B (HBV) or hepatitis C (HCV) type represents a serious medical proble m. In contrast to other countries, detailed statistics on the prevalence of HBV and HCV infection are not available for dialysed patients in Switzerla nd. Methods: The present study is based on a nationwide survey among the Swiss dialysis population which evaluated the prevalence of patients positive for either the HBs antigen (reflecting HBV infection) or anti-HCV antibodies ( reflecting HCV infection) in 1999. From our survey we collected data on 171 3 haemodialysis and 226 peritoneal dialysis patients, representing 92 and 6 5% of the respective dialysis populations in Switzerland. Results: Of all patients (haemodialysis and peritoneal dialysis), 6.59% wer e HBV or HCV marker positive (HBV: 1.44%, HCV: 5.05%). In haemodialysis pat ients the prevalence was clearly higher for HBV (1.63%) and HCV (5.72%) com pared to patients undergoing peritoneal dialysis (0.88 and 3.09% respective ly). Laboratory parameters of hepatitis - as evidenced by an increase in li ver transaminases - were present in 4% of the entire dialysis cohort, 0.6% having an increase in ALAT beyond 1.5 times the normal range. Patients unde rgoing treatment in haemodialysis units which do not implement additional p recautions to prevent the spread of HCV among patients were more likely to be HCV marker positive with laboratory signs of hepatitis. A similar correl ation was observed between HBV or HCV marker positivity and the number of p atients treated per haemodialysis unit. Finally, the percentage of HBV/HCV marker positive patients on the Swiss kidney transplant list is comparable with that of HBV/HCV marker positive patients in the entire dialysis popula tion.