Characteristics of Hepatitis B and C Infections in Hemodialysis Patients in Almaty, Kazakhstan's Largest City.

Arina Yespotayeva 1 2 3 * , Kairat Kabulbayev 2, Almagul Kurmanova 1, Alexander V. Nersesov 3 4, Aigul Raissova 3 4, Venera Ayupova 5 6, Meruyert Suleimenova 1, Nagima Mustapayeva 2, Aisulu Gainutdin 3 4
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1 Faculty of Medicine and Healthcare, Al-Farabi Kazakh National University, Almaty, Kazakhstan
2 Department of Nephrology, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan
3 Outpatient clinic department, Interna Clinic – Institute of Gastroenterology, Hepatology and Metabolism, Almaty, Kazakhstan
4 Department of Gastroenterology, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan
5 Department of Gastroenterology, Multidisciplinary Hospital of Qonayev, Qonayev City, Almaty Region, Kazakhstan
6 Department of Hepatology, City Polyclinic No. 5, Almaty, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 22, Issue 3, pp. 58-63. https://doi.org/10.23950/jcmk/16404
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Author Contributions: Conceptualization: A. V. N.; methodology, A. K.; validation, V. A.; formal analysis, A. G.; investigation, A. R.; resources, N. M.; data curation, M. S.; writing – original draft preparation, A. Y.; writing – review and editing, A. Y.; visualization, A. V. N.; supervision, A.V. N.; project administration, K. K.; funding acquisition, A. Y. All authors have read and agreed to the published version of the manuscript.

Data availability statement: The corresponding author can provide the data supporting the study's conclusions upon request. Due to ethical and privacy constraints, the data are not publicly accessible.

ABSTRACT

Background and aims: Chronic viral hepatitis, including Hepatitis B (HBV) and Hepatitis C (HCV), remains a major health concern among hemodialysis patients. This study analyzes the prevalence and characteristics of HBV and HCV infections in hemodialysis patients treated at a single center in Almaty, focusing on comorbidities such as diabetes, hypertension, and cirrhosis. This study aims to determine the prevalence of these infections among hemodialysis patients in Kazakhstan and assess their associated comorbidities, complications, and overall impact on patient health.
Methods:  Data from the Almaty Center of Hepatology  (2016–2023) served as the basis for the study cohort. Inclusion criteria included CKD stage 5, hemodialysis dependence, ESRD, and confirmed HBV, HCV, or both. The study consists of 164 patients diagnosed with HBV, HCV, or mixed infections, with data collected on demographic distribution, viral genotype prevalence, fibrosis staging, and associated conditions.
Results: The findings highlight a substantial prevalence of comorbid conditions in hemodialysis patients with viral hepatitis. The study population includes 95 males (57.9%) and 69 females (42,1%), with a slight male predominance. HCV was the most common infection (76.8%), followed by HBV (14%) and mixed HCV+HBV (9.2%). The high percentage of an unspecified genotype (36.4%) suggests that enhanced diagnostic strategies are needed. Cirrhosis was observed in nearly 90% of the cohort, and 92.7% exhibited ascites. Fibrosis progression was significant, with 25.5% of patients in stage 1, 24.2% in stage 2, and 18.8% in stage 3. The prevalence of hypertension (53.9% with high-risk stage 3 hypertension), diabetes (14.5% with type 2 diabetes), and cirrhosis (89.7%) was assessed. Additionally, hepatitis genotypes were identified, with HCV genotype three being the most common (18.2%) and genotype 1 (17.6%).
Conclusions: The results of this study demonstrate that patients on hemodialysis with viral hepatitis represent a particularly vulnerable group with a high incidence of severe liver damage and multiple comorbidities. The high rates of advanced fibrosis, cirrhosis, and associated conditions such as hypertension and diabetes underscore the need for timely diagnosis and complex, patient-centered care
Keywords: Hepatitis B, Hepatitis C, Hemodialysis, Chronic Kidney Disease, Comorbidities, Kazakhstan, Liver Cirrhosis, Genotype.

CITATION

Yespotayeva A, Kabulbayev K, Kurmanova A, Nersesov AV, Raissova A, Ayupova V, et al. Characteristics of Hepatitis B and C Infections in Hemodialysis Patients in Almaty, Kazakhstan's Largest City.. J CLIN MED KAZ. 2025;22(3):58-63. https://doi.org/10.23950/jcmk/16404

REFERENCES

  • Jumabayeva A, Nersesov A, Kulzhanov M, Nefedova M, Nuraliyeva G, Rakhimbekova G, Tanabayeva S, Fakhradiyev I. Prevalence of viral hepatitis B, C, and D in Kazakhstan. ScientificWorldJournal. 2022; 2022: 9102565. https://doi.org/10.1155/2022/9102565.
  • Nersesov A, Gusmanov A, Crape B, Junusbekova G, Berkinbayev S, Jumabayeva A, Kaibullayeva J, Madenova S,Novitskaya M, Nazarova M, Gaipov A, Ashimkhanova A, Kadyrzhanuly K, Atageldiyeva K, Vento S, Issanov A. Seroprevalence and risk factors for hepatitis B and hepatitis C in three large regions of Kazakhstan. PLoS One. 2021; 16(12): e0261155. https://doi.org/10.1371/journal.pone.0261155.
  • Ashimkhanova A, Syssoyev D, Gusmanov A, Yesmembetov K, Yespotayeva A, Abbay A, Nurpeissova A, Sarria-Santamera A, Gaipov A. Epidemiological characteristics of chronic viral hepatitis in Kazakhstan: data from Unified Nationwide Electronic Healthcare System 2014–2019. Infect Drug Resist. 2022; 15: 3333–3346. https://doi.org/10.2147/IDR.S363609.
  • Bahtiyar G, Shin JJ, Aytaman A, Sowers JR, McFarlane SI. Association of diabetes and hepatitis C infection: epidemiologic evidence and pathophysiologic insights. Curr Diab Rep. 2004; 4(3): 194–198. https://doi.org/10.1007/s11892-004-0023-7.
  • Khalili M, Lombardero M, Chung RT, Terrault NA, Ghany MG, Kim WR, Lau D, Lisker‐Melman M, Sanyal A, Lok AS. Diabetes and prediabetes in patients with hepatitis B residing in North America. Hepatology. 2015; 62(5): 1364–1374. https://doi.org/10.1002/hep.28110.
  • Petta S, Maida M, Macaluso FS, Barbara M, Licata A, Craxì A, Cammà C. Hepatitis C virus infection is associated with increased cardiovascular mortality: a meta-analysis of observational studies. Gastroenterology. 2016; 150(1): 145–155. https://doi.org/10.1053/j.gastro.2015.09.007.
  • Ilyassova BS, Abzhaparova B, Smailova DS, Bolatov A, Baymakhanov B, Beloussov V, Solomadin M, Shamsivaliyeva K, Alpysbayava G, Issakova G, Granica J, Mukushkina D, Sagatov IY, Kaniyev S. Prevalence and genotypes distribution of virus hepatitis B and hepatitis delta virus in chronic liver diseases in Kazakhstan. BMC Infect Dis. 2023; 23(1): 533. https://doi.org/10.1186/s12879-023-08524-1.
  • Gaipov A, Issanov A, Kadyrzhanuly K, Galiyeva D, Khvan M, Aljofan M, Molnar MZ, Kovesdy CP. Epidemiology of dialysis-treated end-stage renal disease patients in Kazakhstan: data from nationwide large-scale registry 2014–2018. BMC Nephrol. 2020; 21(1): 407. https://doi.org/10.1186/s12882-020-02047-6.
  • Caragea DC, Mihailovici AR, Streba CT, Schenker M, Ungureanu B, Caragea IN, Popa R, Obleaga C, Vere CC. Hepatitis C infection in hemodialysis patients. Curr Health Sci J. 2018; 44(2): 107–112. https://doi.org/10.12865/CHSJ.44.02.02.
  • Vilibic-Cavlek T, Zidovec-Lepej S, Ferenc T, Savic V, Nemeth-Blazic T, Vujica Ferenc M, Bogdanic M, Vilibic M, Simunov B, Janev-Holcer N, Jelicic P, Ljubas D, Kosar T, Ilic M, Kucinar J, Barbic L, Stevanovic V, Mrzljak A. Seroprevalence Trends and Molecular Epidemiology of Viral Hepatitis in Croatia. Life (Basel). 2023; 13(1): 224. https://doi.org/10.3390/life13010224.
  • Golkocheva-Markova E, Ismailova C, Kevorkyan A, Raycheva R, Zhelyazkova S, Kotsev S, Pishmisheva M, Rangelova V, Stoyanova A, Yoncheva V, Tenev T, Gladnishka T, Trifonova I, Christova I, Dimitrov R, Bruni R, Ciccaglione AR. Age and Gender Trends in the Prevalence of Markers for Hepatitis E Virus Exposure in the Heterogeneous Bulgarian Population. Life (Basel). https://doi.org/10.3390/life13061345.
  • Adane T, Getawa S. The prevalence and associated factors of hepatitis B and C virus in hemodialysis patients in Africa: A systematic review and meta-analysis. PLoS One. 2021; 16(6): e0251570. https://doi.org/10.1371/journal.pone.0251570.
  • Hsu PY, Wei YJ, Liang PC, Lee JJ, Niu SW, Huang JC, Hsu CT, Jang TY, Huang CI, Lin YH, Hsieh MY, Hsieh MH, Chen SC, Dai CY, Lin ZY, Chen SC, Huang JF, Chang JM, Yeh ML, Huang CF, Chiu YW, Hwang SJ, Chuang WL, Yu ML. Comorbidities in patients with chronic hepatitis C and hepatitis B on hemodialysis. J Gastroenterol Hepatol. 2021; 36(8): 2261–2269. https://doi.org/10.1111/jgh.15480.
  • Karaulov Y, Yespotayeva A, Musslim B, Sagatbayev J, Kaldybekova E, Kabulbayev K, Kanatbayeva A, Amreeva Z, Dabyltayeva K. Epidemiology of histologically proven glomerulonephritis in kazakhstan. Journal of Clinical Medicine of Kazakhstan. 2018; 2(48 suppl 1): 24.
  • Yespotayeva A, Kabulbayev K, Kanatbayeva A, Amreeva Z. Proton pump inhibitor use and risk of progression of chronic kidney disease in our practice and a systematic review. Journal of Clinical Medicine of Kazakhstan. 2018; 2 (48 suppl 1): 35.
  • Soi V, Daifi C, Yee J, Adams E. Pathophysiology and Treatment of Hepatitis B and C Infections in Patients With End-Stage Renal Disease. Adv Chronic Kidney Dis. 2019; 26(1): 41–50. https://doi.org/10.1053/j.ackd.2018.10.004.
  • Marc L, Mihaescu A, Lupusoru R, Schiller O, Bob F, Chisavu L, Bende F, Sirli R, Schiller A. Hepatitis C and hepatitis B virus infection in hemodialysis patients after nationwide direct antiviral agents therapy-experience of 10 Romanian HD centers. Int Urol Nephrol. 2023; 55(11): 2951–2958. https://doi.org/10.1007/s11255-023-03587-0.