engleski

Hepatitis E virus among patients on haemodialysis in Croatia

Background: Hepatitis E virus (HEV) infection is an emerging infectious disease in many European countries. Previous studies in Europe indicate that HEV seroprevalence among patients on maintenance haemodialysis (HD) ranges from 1% to 37%. Risk factors for HEV infection among HD recipients are not fully understood. The aim of this study was to determine the prevalence and risk factors for HEV infection among HD recipients in Croatia, to propose recommendations for preventive measures. Methods: We implemented a cross-sectional study, inviting 515 individuals on HD from 6 medical facilities in 5 Croatian cities.Three facilities are in the continental region (Zagreb sites 1 and 2, and Osijek) and 3 in the coastal region (Sibenik, Dubrovnik and Pula). A self-administered questionnaire elicited risk factors for HEV infection: age, gender, food and water consumption, travel, household composition, animal contact, transfusion history and hemodialysis duration. Blood samples were tested for IgG HEV antibody using an enzyme immunoassay. Results: A total of 392 HD recipients (76%) participated ; their median age was 70.5 years (range 21-92 years) and 145 (37%) were female. IgG HEV antibodies were detected in 125 (32%) of participants. Multiple logistic regression indicated that age (OR=1.03 ; 95%CI=1.01-1.05) and living in the continental region (OR=3.55 ; 95%CI=2.12-5.96) were risk factors for HEV seropositivity. Conclusions: Almost 1/3 of HD recipients in Croatia had been exposed to HEV, which is among the highest seroprevalence rates reported in Europe. As HEV infection has been documented among pigs in the continental region of Croatia, we hypothesize that traditional pork- based food consumption could be an important risk factor, and should be investigated further. Routine HEV screening among HD recipients is recommended in this part of Croatia.

hepatitis E virus ; haemodialysis ; Croatia

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