Decreased risk of nosocomial transmission of hepatitis B and C viruses among hemodialysis patients in Southern Bulgaria

Authors

  • Radka T Komitova Department of Infectious Diseases, Parasitology and Tropical Medicine, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
  • Elitsa N Golkocheva-Markova National Reference Laboratory “Hepatitis Viruses”, Department of Virology, National Center of Infectious and parasitic Diseases, Sofia, Bulgaria https://orcid.org/0000-0002-3462-866X
  • Ani K Kevorkyan Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
  • Lubomira Nikolaeva-Glomb National Reference Laboratory of Enteroviruses, National Center for Infectious and Parasitic Diseases, Sofia, Bulgaria https://orcid.org/0000-0002-8008-2821
  • Vanya R Rangelova Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
  • Tanya I Kostadinova First Dialysis Services Bulgaria, Plovdiv, Bulgaria
  • Tsvetelina Chardakova First Dialysis Services Bulgaria, Pazardzhik, Bulgaria
  • Mariya V Atanasova Department of Microbiology and Immunology “Prof. Dr. Elissay Yanev”, Faculty of Pharmacy, Medical University of Plovdiv, Bulgaria
  • Tencho D Tenev National Reference Laboratory “Hepatitis Viruses”, Department of Virology, National Center of Infectious and parasitic Diseases, Sofia, Bulgaria https://orcid.org/0000-0001-6334-3447
  • George S Kiprin Department of Gastroenterology, Eurohospital, Plovidiv, Bulgaria
  • Simon K Sariyan Department of Gastroenterology, University Hospital “St. George”, Plovdiv, Bulgaria
  • Ralitsa D Raycheva Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria https://orcid.org/0000-0002-6417-5681
  • Valeri D Tzekov Section of Nephrology, Second Department of Internal Medicine, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria

DOI:

https://doi.org/10.3855/jidc.20035

Keywords:

Hepatitis B, hepatitis C, hemodialysis, nosocomial transmission, viremia

Abstract

Introduction: Hepatitis B (HBV) and (HCV) virus infections represent a nosocomial risk in hemodialysis (HD) patients. We aimed to evaluate the risk among adult HD patients in southern Bulgaria.

Methodology: A prospective cohort study included 225 patients from three HD centers between January 2020 and June 2022. HBV and HCV infections were characterized by serological and virological markers determined through enzyme-linked immunosorbent assay and polymerase chain reaction.

Results: HBV infection was detected in 13 patients and HCV in 15. Ten of the hepatitis patients died of non-liver-related complications. Sustained virological response (SVR) was confirmed in five HCV-infected patients previously cured with direct-acting antivirals (DAAs). Five patients were viremic. Three of them achieved SVR after DAAs, and two refused treatments. A decrease in HCV viremia prevalence (2.22% versus 0.89%) was recorded (p = 0.15). Virological suppression was confirmed in four HBV-infected patients treated with nucleos(t)ide analogs. Тwo patients were not eligible for antivirals. Decreased HBV viremia prevalence (2.7% versus 0.89%) was recorded (p = 0.15). Among HBV surface antigen (HBsAg)-negative patients, HBV vaccination coverage was 62.74% (133/212) and higher in 2 HD centers (128/137; 93.43%). Nevertheless, one-third of participants (34/112; 30.36%) were susceptible to HBV. Twenty-four vaccinees (24/112; 21.43%) had acquired natural immunity but remained at risk of reactivation in case of immunosuppression. HBV DNA was detected in eight HBsAg-negative patients, resulting in a prevalence of 7.14% (8/112) for occult HBV infection.

Conclusions: The study reveals a downward trend in HBV and HCV viremia prevalence among HD patients. To further reduce the risk of nosocomial transmission, vaccination for hepatitis B requires updating.

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Published

2025-05-31

How to Cite

1.
Komitova RT, Golkocheva-Markova EN, Kevorkyan AK, Nikolaeva-Glomb L, Rangelova VR, Kostadinova TI, Chardakova T, Atanasova MV, Tenev TD, Kiprin GS, Sariyan SK, Raycheva RD, Tzekov VD (2025) Decreased risk of nosocomial transmission of hepatitis B and C viruses among hemodialysis patients in Southern Bulgaria. J Infect Dev Ctries 19:782–791. doi: 10.3855/jidc.20035

Issue

Vol. 19 No. 05: May 2025

Section

Original Articles

License

Copyright (c) 2025 Radka Komitova, Elitsa Golkocheva-Markova, Ani Kevorkyan, Lubomira Nikolaeva-Glomb, Vanya Rangelova, Tanya Kostadinova, Tsvetelina Chardakova, Mariya Atanasova, Tencho Tenev, George Kiprin, Simon Sariyan, Ralitsa Raycheva, Valeri Tzekov

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