Prevalent coinfection and associated factors for Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus in patients submitted to renal replacement therapy: A cross-sectional study of 21 dialysis units in the State of Mexico

PLoS One. 2022 Dec 1;17(12):e0275238. doi: 10.1371/journal.pone.0275238. eCollection 2022.

Abstract

Background: Chronic kidney disease (CKD) predispose to viral coinfections in patients submitted to renal replacement therapy (RRT); nevertheless, few reports have been performed to elucidate the current epidemiology within this population in Mexico.

Aim: To estimate the prevalence of HBV, HCV, and HIV coinfection and to explore factors associated with prevalent coinfection in patients living with renal failure undergoing to RRT.

Methods: A multicenter cross-sectional recruitment across 21 units at the Mexican Institute of Social Security (IMSS) at the State of Mexico was performed during 2019. A standardized clinical questionnaire was performed to elucidate individual and relatives-related conditions. A treatment facility questionnaire was applied to the chief responsible of each unit to explore treatment facility variables. Serological testing, clinical, biochemical, and anthropometrical parameters were extracted from clinical records.

Result: In 1,304 patients (57.5% male, mean age 45.5 (SD: 15.6) years, and 95.8% in hemodialysis), the prevalence of any viral coinfection was 3.14% (95% CI: 2.32%-4.23%). The highest viral coinfection prevalence were for HCV, HBV, and HIV, in which men and subjects diagnosed after 2010's had the highest rates. We identify that being submitted to peritoneal dialysis, being treated in a surrogated dialysis center and living with a close relative with prior hepatitis coinfection were associated factors for any viral coinfection.

Conclusion: In patients submitted to RRT, the prevalence of viral coinfection remains high compared with general population. Screening strategies, medical awareness and targeted public healthcare policies should prioritize better care practices within patients submitted to RRT in Mexico.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Coinfection* / epidemiology
  • Cross-Sectional Studies
  • Female
  • HIV
  • HIV Infections* / complications
  • HIV Infections* / epidemiology
  • Hepacivirus
  • Hepatitis B* / complications
  • Hepatitis B* / epidemiology
  • Hepatitis C* / complications
  • Hepatitis C* / epidemiology
  • Humans
  • Male
  • Mexico / epidemiology
  • Middle Aged
  • Renal Dialysis
  • Renal Replacement Therapy

Grants and funding

This work was funded by “AbbVie Farmacéuticos S.A. de C.V”. The funder provided support in the form of salaries to the team of 9 nurses that were recruited for the study to obtain the clinical information from clinical records of the patients included in the study. The Investigation and Ethics Review Board of the IMSS approved this study and the funding under the protocol number R-2017-785-081. The sponsor only provided the salaries but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section. This does not alter our adherence to PLOS ONE policies on sharing data and materials.