Global epidemiology of HBV infection among hemodialysis patients: A systematic review and meta-analysis

Zohreh Khalesi; Mohammad Hossein Razizadeh; Mahsa Javadi; Atefeh Bahavar; Zahra Keyvanlou; Hassan Saadati; Arash Letafati; Alireza Khatami; Atefeh Kachooei; Pegah Khales; Ehsan Alborzi; Mahdiyeh Hosseini; Vahid Tambrchi; Elham Jafari Maskouni; Nafiseh Taheri; Alireza Zafarani; Saeed Motlaghzadeh; Hamid Dehghani; Nadia Shalpoush; Alireza Masoudi; Marzieh Noorafza; Zahra Habib; Mohammad Zarei; Seyed Jalal Kiani; Saied Ghorbani

doi:10.1016/j.micpath.2023.106080

Global epidemiology of HBV infection among hemodialysis patients: A systematic review and meta-analysis

Microb Pathog. 2023 Jun:179:106080. doi: 10.1016/j.micpath.2023.106080. Epub 2023 Mar 21.

Authors

Zohreh Khalesi¹, Mohammad Hossein Razizadeh², Mahsa Javadi³, Atefeh Bahavar⁴, Zahra Keyvanlou⁵, Hassan Saadati⁶, Arash Letafati¹, Alireza Khatami², Atefeh Kachooei², Pegah Khales⁷, Ehsan Alborzi², Mahdiyeh Hosseini², Vahid Tambrchi⁴, Elham Jafari Maskouni⁸, Nafiseh Taheri⁸, Alireza Zafarani⁹, Saeed Motlaghzadeh², Hamid Dehghani¹⁰, Nadia Shalpoush¹¹, Alireza Masoudi¹², Marzieh Noorafza¹³, Zahra Habib², Mohammad Zarei¹⁴, Seyed Jalal Kiani¹⁵, Saied Ghorbani¹⁶

Affiliations

¹ Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
² Department of Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
³ Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
⁴ Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
⁵ Department of Virology, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran.
⁶ Department of Epidemiology and Biostatistics, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran.
⁷ Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
⁸ Department of Microbiology and Virology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
⁹ Department of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran.
¹⁰ Department of Biology, Jahrom Branch, Islamic Azad University, Fars, Iran.
¹¹ Biology Cellular and Molecular Microbiology, Islamic Azad University of Medical Sciences, Tehran, Iran.
¹² Department of Laboratory Sciences, Faculty of Allied Medical Sciences, Medical University of Qom, Qom, Iran.
¹³ Department of Microbiology, Faculty of Basic Sciences, Rasht Branch, Islamic Azad University, Rasht, Iran.
¹⁴ Renal Division, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA; John B. Little Center for Radiation Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
¹⁵ Department of Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran. Electronic address: kiani.j@iums.ac.ir.
¹⁶ Department of Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran. Electronic address: Vet.S.Ghorbani@gmail.com.

PMID: 36948364
DOI: 10.1016/j.micpath.2023.106080

Abstract

Background & aims: Hemodialysis (HD) is a life-saving procedure that purifies the blood in patients with end-stage renal disease (ESRD). Among all major complications, blood-borne diseases like hepatitis B virus (HBV) may be exposed as serious side effects of hemodialysis. A comprehensive review of the global burden of HBV among HD patients has not been written so far. The aim of the current systematic review and meta-analysis was to determine the globally epidemiology of HBV infection among HD patients.

Methods: Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, articles that investigated the prevalence of HBV among HD patients were searched from the major databases such as EMBASE, PubMed, Web of Science collection, and Scopus. Pooled prevalence with 95% CI and identification of heterogeneity were obtained using the random effects model and Cochran's Q-test, respectively, and quantification was evaluated using the I2 statistics. All statistical analyses were performed by STATA 14.1 statistical software.

Results: among 322 datasets (795,623 cases) that included in this study, the pooled prevalence of HBV infection among HD patients was 7.32% (95% CI: 6.53-8.15%; I2 = 97.91%), including 7.57% (95% CI: 6.69-8.48%) for HBsAg and 6.09% (95% CI: 4.05-8.49%) for DNA, respectively. In addition, based on geographic area, the prevalence was 7.44% (95% CI: 6.35-8.61%) in Asia, 4.32% (95% CI: 2.21-7.04%) in North America, 7.07% (95% CI: 6.35-8.61%) in Europe, 5.52% (95% CI: 3.60-7.78%) in Africa, 8.45% (95% CI: 5.81-11.78%) in Oceania, and 9.73% (95% CI: 7.11-12.70%) in South America.

Conclusions: Our analysis indicates a relatively high prevalence of HBV infection in HD patients, even in some developed countries. Considering that ESRD patients are not able to properly respond to the vaccination strategies in order to develop an acceptable immunity, vaccination of healthy individuals is highly recommended to arm their bodies for possible immunocompromise conditions in the future. Moreover, donated blood in blood transfusion centers should be checked for possible hepatitis B virus infection using sensitive molecular tests.

Keywords: Epidemiology; HBV; Hepatitis B infection; Meta-analysis.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Hepatitis B Surface Antigens
Hepatitis B virus / genetics
Hepatitis B* / epidemiology
Humans
Kidney Failure, Chronic* / complications
Kidney Failure, Chronic* / epidemiology
Kidney Failure, Chronic* / therapy
Prevalence
Renal Dialysis / adverse effects

Substances

Hepatitis B Surface Antigens