Viral hepatitis, HIV, human herpes virus and Treponema pallidum infection in haemodialysis patients from Kosovo, 2005

G L Quaglio; C Pattaro; N Ramadani; L Bertinato; Y Elezi; P Dentico; A Volpe; M Ciotti; G Rezza; G Putoto

doi:10.2807/ese.14.49.19439-en

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Viral hepatitis, HIV, human herpes virus and Treponema pallidum infection in haemodialysis patients from Kosovo, 2005
G L Quaglio¹ , C Pattaro² , N Ramadani³ , L Bertinato¹ , Y Elezi⁴ , P Dentico⁵ , A Volpe⁵ , M Ciotti⁶ , G Rezza⁷ , G Putoto¹
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Affiliations: ¹ Veneto Region, Italian Co-operation, Peja Training Project Team, Venice, Italy ² European Academy (EURAC), Bozen/Bolzano, Italy - Affiliated Institute of the University Lübeck, Germany ³ National Institute of Public Health, Pristhine, Kosovo ⁴ Nephrology Unit, Department of Internal Medicine, University of Prishtine, Kosovo ⁵ Institute of Internal Medicine, University of Bari, Italy ⁶ European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden ⁷ Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy

Correspondence:
G Quaglio
gianluca.quaglio azosp.vr.it
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Citation style for this article: Quaglio G L, Pattaro C, Ramadani N, Bertinato L, Elezi Y, Dentico P, Volpe A, Ciotti M, Rezza G, Putoto G. Viral hepatitis, HIV, human herpes virus and Treponema pallidum infection in haemodialysis patients from Kosovo, 2005. Euro Surveill. 2009;14(49):pii=19439. https://doi.org/10.2807/ese.14.49.19439-en Received: 27 Jul 2009

Abstract

The serological status of hepatitis viruses and other infectious diseases in the 66 dialysed patients of one haemodialysis unit in Kosovo were studied, comparing the data with a large group of blood donors and out-patients. All dialysed patients were hepatitis A virus (HAV) positive. Prevalence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (anti-HBs), and hepatitis B core antibodies (anti-HBc) was 14 of 66, 21% (95% confidence interval (CI): 12-33%), 5 of 66, 8% (95%CI: 5-22%), and 50 of 66, 76% (95%CI: 64-85%), respectively. Antibodies to hepatitis C virus (anti-HCV) prevalence was 57 of 66, 86% (95%CI: 76-94%). No human immunodeficiency virus (HIV) positive case was found. Prevalence of past herpes simplex virus type 2 (HSV-2) infection was 29% (95%CI: 18-41%). Two patients (3%, 95%CI: 0-10%) were positive for Treponema pallidum and 18% (95%CI: 10-30%) were human herpesvirus 8 (HHV-8) antibody positive. Four hundred and fifty-two subjects were recruited for comparison. Markers of past HAV infection was associated with haemodialysis (Fisher's exact test p-value=0.037). Dialysed patients were at a higher risk of being HBsAg positive than others: the sex- and age-adjusted odds ratio (OR) was 5.18 (95%CI: 1.87-14.32). Anti-HBc positivity was strongly associated with haemodialysis: the sex- and age-adjusted OR was 6.43 (95%CI: 3.22-12-85). Anti-HCV positivity was 86% and 1% in presence and absence of haemodialysis, respectively. The Fisher's exact test for association proved a strong association between haemodialysis and HCV (p-value<0.0001). The OR for association between haemodialysis and HSV-2 positivity was 3.20 (95%CI: 1.46-7.00). Significant associations were also observed between haemodialysis status and antibodies to Treponema pallidum (Fisher's exact test p-value=0.044). In Kosovo, the prevalence of viral hepatitis infection and other viral infections and Treponema pallidum among dialysed patients is high, indicating major ongoing nosocomial transmission. .