Hepatitis B Infection among Patients Receiving Chronic Hemodialysis at the Royal Medical Services in Jordan

Hepatitis B virus (HBV) infection is a major clinical problem in patients on maintenance hemodialysis (HD) and can lead to many serious consequences. This study was carried out in order to determine the prevalence of HBV infection and the possible risk factors for acquiring it, in patients on maintenance HD. All patients on regular HD in seven hospitals of the Royal Medical Services, Amman, Jordan, were studied during the period between July and December 2006. The medical history and records of these patients were reviewed for the presence of hepatitis B surface antigen (HbsAg), and possible risk factors for acquiring this infection. A total of 430 patients on HD with a mean age of 47.3 years were studied. Three patients, who were positive for HBsAg before starting dialysis, were excluded from the study. The remaining 427 patients, who were HBsAg negative before starting dialysis were included. Of these, 25 (5.9%) became HbsAg-positive during the study period. Being on HD for longer than two years and positive history of blood transfusion(s) were more frequently noticed in the HbsAg­positive group (88% and 60% respectively) compared with the HbsAg-negative group (43% and 56% respectively). Of 379/402 (94%) patients who remained Hbs Ag-negative and 1/25 (4%) of those who converted to Hbs Ag-positive were reportedly vaccinated. Our study suggests that the prevalence of HbsAg positivity in our HD patients was 5.9%. Dialysis for more than two years, but not history of blood transfusions, was noted to be a significant risk factor for acquiring this infection. Vaccination against the HBV gives good protection against this virus.