Hepatitis B and hepatitis C testing practices and observed seroconversions among dialysis facilities in Georgia

BackgroundIndividuals receiving hemodialysis for end-stage kidney disease are at increased risk of infection with hepatitis C virus (HCV) and hepatitis B virus (HBV) due to regular and frequent receipt of invasive medical treatment in a shared space.AimThis study assessed infection prevention and control practices in dialysis facilities, evaluated HCV and HBV testing practices, and estimated the number of cases of seroconversion for HCV and HBV infection in dialysis facilities in Georgia.MethodsWe invited all 27 dialysis centers that provide maintenance dialysis in Georgia to participate in a facility-based survey during April-June 2021.ResultsIn total, 68.2% (n = 15/22) of facilities performed anti-HCV screening upon admission to the center. At the majority of facilities (n = 21/22, 95.5%), HBV screening was performed upon admission to the center. A total of 329 anti-HCV positive patients were reported from 20 of 22 facilities, 29.5% (n = 97/329) were HCV RNA positive, 18.2% (n = 60/329) were HCV RNA negative, and 52.3% (n = 172/329) were not tested or their result was missing. Overall, 200 HBsAg-positive patients were reported from the same 20 facilities. At 10 facilities: 39 patients from seven facilities seroconverted for HCV infection, and 31 patients from eight dialysis facilities seroconverted for HBV infection.ConclusionsWe identified a high number of HBV and HCV seroconversions among dialysis patients in Georgia suggesting serious gaps in infection control practices. Strict adherence to infection prevention and control practices is essential to prevent transmission of HCV and HBV infections through contaminated equipment and surfaces.