Dialysis patients at high risk

Claiming close to 1.5 million lives every year, viral hepatitis is the world’s eighth biggest killer. Today, only one in 20 people with viral hepatitis know that they have contracted it, and only one in 100 with the disease is being treated on time worldwide, says WHO. Out of all five types of viral hepatitis, Hepatitis B and C are considered to more chronic and serious from the clinical point of view.

While there are many risk factors for Hepatitis B and C, patients of chronic kidney disease undergoing haemodialysis are at high risk of acquiring both forms of infection due to a lack of focussed adherence of safety protocols and unsafe practices among the medical community.

The process of dialysis requires high degree of safety standards with dedicated and separate units for infected patients. Hepatitis C infection can be highly dangerous, even fatal for patients with chronic kidney diseases undergoing dialysis procedures on a regular basis.

However, such safety practices are not adhered to in many smaller centres, particularly in the rural belts, putting kidney disease patients at an added risk of infections. Inadequate screening during blood transfusions and dialysis plays a significant role in the spread of the virus in the patients we see in our city.

Many a times, staff and personnel handling clinical processes are often not properly trained to meet the required hygiene standards. To minimise infection, blood transfusions must be avoided as much as possible and other mechanisms must be followed, such as using drugs to treat anaemia, and supplementing with intravenous iron therapy if needed.

At the same time, needles and syringes should be destroyed after usage to avoid recycling. Patients on dialysis should be tested and monitored periodically. Most importantly, all patients must be religiously screened before dialysis and separate units must be used for the infected and non-infected patients.

Although robust awareness against the modes of transmission and risk factors are somewhat missing till date in Andhra Pradesh and Telangana, the good news is that with the availability of newer oral antiviral drugs against Hepatitis C has made its treatment more economical as well as patient-friendly.

On the other hand, immunisation via vaccines for HBV virus is nowadays being seen to be implemented in a more comprehensive manner in the state. Patients who underwent blood transfusions, dialysis or kidney related surgeries as long ago as the 1990s are at an equal risk of having acquired infection.

All high-risk individuals must get themselves screened to detect the virus for timely diagnosis and treatment, and even after symptoms of liver damage subside, people should continue with follow-up checks. (The writer is Chief of Gastroenterology & Hepatology, Apollo Hospital, Hyderabad)

By Dr K Soma Sekhar Rao