Seroprevalence of Hepatitis A, Hepatitis B, Hepatitis C, and HIV Among Patients Undergoing First Hemodialysis in the Emergency Department: A Retrospective Cross- Sectional Study
This retrospective cross-sectional study of 218 patients undergoing their first hemodialysis in an emergency department found a 47.2% seroprevalence of past Hepatitis A infection, 4.1% for Hepatitis B, and 3.7% for Hepatitis C, with no active HIV or acute viral infections detected, while identifying female gender as a significant risk factor for Hepatitis C positivity.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Viruses that travel through blood and bodily fluids pose a persistent challenge to public health, particularly for people whose bodies cannot filter waste from their blood naturally. When kidneys fail, patients require hemodialysis, a life-sustaining treatment where a machine cleans the blood outside the body. This process involves frequent connections to the bloodstream, creating a potential pathway for viruses to enter or spread if strict hygiene is not maintained. Among the most concerning of these are hepatitis B and hepatitis C, which can damage the liver over time, and HIV, which attacks the immune system. While vaccines and better safety practices have reduced the spread of these infections in many places, doctors still need to know exactly which viruses are present in patients before they start treatment. This is especially true for those who arrive at a hospital emergency room needing dialysis for the first time, often in a state of crisis, where there is no prior medical history to guide safety precautions.
A team of researchers at Dokuz Eylül University in Turkey set out to map the viral landscape for this specific group. They looked back at the medical records of 218 adults who came to their emergency department between July 2023 and June 2025 to receive their very first hemodialysis session. The team excluded anyone who had already been on dialysis for a long time or had temporary treatments in the past, focusing strictly on the moment these patients entered the system. By reviewing the blood tests taken right before or during that first session, the researchers could see what viruses were already present in the patients' bodies before the hospital care began. They checked for signs of past or current infection with hepatitis A, hepatitis B, hepatitis C, and HIV.
The results revealed a clear picture of the viral risks facing these patients. Nearly half of the group, 47.2 percent, showed signs of having encountered hepatitis A at some point in their lives, though none had an active, new infection. For hepatitis B, the researchers found that 4.1 percent of the patients carried the virus, a rate slightly higher than what is typically seen in patients who have been on dialysis for years. For hepatitis C, 3.7 percent of the patients tested positive. Interestingly, the study found a distinct difference between men and women regarding hepatitis C: the virus was found in 7.4 percent of the women but only 0.8 percent of the men. No one in the group tested positive for HIV or for the active, early stages of hepatitis B or hepatitis A infections.
The researchers also looked to see if common health factors, such as diabetes, cancer, a history of surgery, or previous blood transfusions, made a person more likely to carry these viruses. They found no such links. The presence of hepatitis B or C did not depend on age, gender (except for the specific hepatitis C finding in women), or these other medical histories. The study suggests that the risk of carrying these viruses in this group is not simply a result of having other serious illnesses or having received blood in the past, but rather reflects the complex background of each individual. The absence of HIV in this group aligns with what is known about the low rates of the virus in dialysis patients in Turkey, though the small number of people in the study means this result is specific to this group and time.
This work highlights that even before a patient begins the routine of dialysis, a significant portion carries viruses that require careful management. The finding that nearly half the patients had immunity to hepatitis A, while others did not, suggests that checking vaccination status could be a valuable step for future care. The study does not claim to solve the problem of viral spread in dialysis, but it provides a crucial snapshot of the starting line. By knowing exactly who carries which virus at the moment they arrive at the emergency room, doctors can immediately put the right safety measures in place to protect both the patient and the medical staff, ensuring that the life-saving treatment does not become a vector for further infection.
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