Transcript CHAPTER 10 Hepatitis on Dialysis

CHAPTER 10
Hepatitis on Dialysis
Teo Sue Mei
Clare Tan Hui Hong
Chow Yok Wai
T. Thiruventhiran
Ng Eng Khim
Source: 20th MDTR Report 2012, NRR
Table 10.1: Prevalence of positive HBsAg and positive Anti-HCV
at annual survey, HD patients 1993-2012
Year
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Number of
patients
1694
2139
2991
4384
5187
6106
6977
7618
8957
11295
12496
14951
17353
18829
22107
25239
Prevalence of HBsAg+ (%)
Prevalence of Anti-HCV+ (%)
6
6
6
6
6
5
5
5
4
5
5
4
4
4
4
4
23
22
23
25
23
20
19
17
14
12
11
9
8
7
6
5
Source: 20th MDTR Report 2012, NRR
Table 10.2: Prevalence of positive HBsAg and positive Anti-HCV
at annual survey, PD patients 1993-2012
Year
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Number of
patients
476
541
610
662
781
891
1223
1200
1318
1494
1731
2017
2144
2280
2521
2853
Prevalence of HBsAg+ (%)
Prevalence of Anti-HCV+ (%)
3
3
2
2
2
3
3
4
4
5
5
4
4
3
3
3
5
6
5
5
3
4
4
5
5
4
4
3
3
3
3
2
Source: 20th MDTR Report 2012, NRR
Table 10.3: Variation in Proportion of patients with positive
HBsAg at annual survey among HD centres, 1993-2012
Year
Number of
centres
Min
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
45
50
74
105
127
152
182
211
239
289
321
370
415
451
509
561
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5th
Centil
e
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
LQ
Median
UQ
95th Centile
Max
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
5
4.5
4
5
3
3.5
3
2
1
0
0
0
0
0
0
9
9
10
9
9
8
8
8
7
6
7
6
5
5
4
4
17
19
19
16
17
14
17
15
17
16
15
12
13
12
12
12
20
23
30
82
91
28
73
92
100
94
100
100
96
100
100
100
Source: 20th MDTR Report 2012, NRR
Figure 10.3: Variation in proportion of patients with positive
HBsAg among HD centres, 2012
% with positive HBsAg
(lower 95% CI, upper 95% CI)
100
90
80
% patients
70
60
50
40
30
20
10
0
0
50
100
150
200
250 300
Centre
350
400
450
500
550
Source: 20th MDTR Report 2012, NRR
Table 10.4: Variation in proportion of patients with positive
HBsAg at annual survey among PD centres, 1993-2012
Year
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Number of
centres
7
9
10
11
12
15
18
18
19
22
22
24
25
25
28
28
Min
5th Centile
LQ
Median
UQ
95th Centile
Max
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
1
1
2
0
0.5
0
1
0
0
2
1
2
1
2
3
4
3
3
4
4
3
3
3
2
2
3
3
2
4
3
6
6
5
5
6
6
5
5
4
4.5
3.5
8
6
4
5
9
18
8
11
10
9
8
10
9
6
6
5
8
6
4
5
9
18
8
11
10
13
11
13
10
7
16
6
Source: 20th MDTR Report 2012, NRR
Figure 10.4: Variation in proportion of patients with positive
HBsAg among PD centres, 2012
% with positive HBsAg
(lower 95% CI, upper 95% CI)
100
90
80
% patients
70
60
50
40
30
20
10
0
0
2
4
6
8
10
12
14 16
Centre
18
20
22
24
26
28
Source: 20th MDTR Report 2012, NRR
Table 10.5: Variation in proportion of patients with positive antiHCV at annual survey among HD centres, 1993-2012
Year
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Number of
centre
45
50
74
105
127
152
182
214
241
287
320
370
415
451
508
560
Min
5th centile
LQ
Median
UQ
95th centile
Max
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
12
7
9
5
5
6
4
0
0
0
0
0
0
0
0
21
18.5
20
18
17
14.5
13
12
10
8
7
4.5
3
0
0
0
30
30
29
31
31
25.5
24
25
21
18
15
13
10
9
7
6
57
63
57
67
64
54
48
50
40
41
35.5
31
27
23
21
19
70
77
78
88
88
94
90
100
98
98
100
100
98
98
100
100
Source: 20th MDTR Report 2012, NRR
Figure 10.5: Variation in proportion of patients with positive antiHCV among HD centres, 2012
% with positive anti-HCV
(lower 95% CI, upper 95% CI)
100
90
80
% patients
70
60
50
40
30
20
10
0
0
50
100
150
200
250 300
Centre
350
400
450
500
550
Source: 20th MDTR Report 2012, NRR
Table 10.6: Variation in proportion of patients with positive antiHCV at annual survey among PD centres, 1993-2012
Year
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Number of
centre
7
9
10
11
12
15
18
18
19
22
22
24
25
25
27
28
Min
5th centile
LQ
Median
UQ
95th centile
Max
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
3
2
0
0
1
1
2
2
1
0
0
0
0
0
6
3
4
3
3
3
4.5
4.5
4
2.5
2.5
4
2
2
2
1
7
8
7
8
4
8
7
7
8
6
6
4
4
3
4
3
9
11
14
10
7
11
9
10
11
8
8
6
8
5
11
7
9
11
14
10
7
11
9
10
11
11
9
9
20
20
12
10
Source: 20th MDTR Report 2012, NRR
Figure 10.6: Variation in proportion of patients with positive antiHCV among PD centres, 2012
% with positive anti-HCV
(lower 95% CI, upper 95% CI)
100
90
80
% patients
70
60
50
40
30
20
10
0
0
2
4
6
8
10
12
14 16
Centre
18
20
22
24
26
28
Source: 20th MDTR Report 2012, NRR
Table 10.7(a): Risk factors in relation to HD practices for
seroconversion to anti-HCV positive among sero-negative patients
1993-2012
Source: 20th MDTR Report 2012, NRR
Table 10.7(b): Risk factors for seroconversion to anti-HCV positive
among sero-negative patients in PD 1993-2012
Risk factor
Age
<=20 (ref*)
21-40
41-60
>60
Gender
Female (ref*)
Male
Diabetes
No (ref*)
Yes
Previous Renal
Transplant
No (ref*)
Yes
History of Blood
Transfusion
No (ref*)
Yes
Total Patients
Number of patients
Sero converted
Risk Ratio
95% CI
p-value
377
743
1807
1785
10
30
53
24
1.00
2.28
1.75
0.99
(1.11;4.68)
(0.85;3.62)
(0.45;2.2)
0.024
0.128
0.988
2358
2354
52
65
1.00
1.31
(0.91;1.88)
0.148
2683
2029
77
40
1.00
0.78
(0.52;1.19)
0.247
4517
195
107
10
1.00
1.71
(0.86;3.38)
0.126
3051
1661
98
19
1.00
0.74
(0.46;1.21)
0.233