Epidemiology and Frequency of Cytomegalovirus among Patients Undergoing Hemodialysis in the Tertiary Care Center

Introduction: One of the most important pathogen among immunocompromised patients, those who needs regular blood transfusion and renal failure patients undergoing hemodialysis is cytomegalovirus (CMV). Several risk factors such as blood transfusion, transplantation, hemodialysis and the frequency and duration of dialysis can be associated with this infection. The highest prevalence of CMV has been reported in Asia, Africa and South-America and the lowest in USA and Western Europe. The objective of this study is to determine the epidemiology and frequency of cytomegalovirus in patients undergoing hemodialysis. Methods: This cross-sectional study was performed on all of the hemodialysis patients of Mazandaran Hear Center’s dialysis unit in 2018. Data were collected from 180 patients undergoing hemodialysis in this health care center. To include the patients we considered sociodemographic characteristics, blood transfusion history and period, duration and frequency/week of hemodialysis. Blood samples were collected from all patients and after centrifuge, serum samples were analyzed for CMV-specific immunoglobulin G (IgG) using enzyme-linked immunosorbent assay (ELISA) technique. The Statistical Package for the Social Sciences 16.0 (SPSS Inc., Chicago, IL, USA) with Chi-squared test was used for data analysis. The cut-off point for P-value was set at 0.05. Findings: Of all 180 patients, 93 (51.7%) were female and 87 (48.3%) were male with mean age of 61.5 (±14.4). Average period of hemodialysis was 29.1 (±37.6) months. Average hemodialysis duration was 3.8 (±0.4) with mode of three times per week. Most of the patients (73.9%) had the history of blood transfusion. All of the patients (100%) were positive for anti-CMV IgG antibody. We could not found any relationship between the antibody titer and sex (P-value=0.55), age (P-value=1.00), transfusion (P-value=0.28), dialysis period (P-value=0.60), dialysis duration (P-value=0.17), or frequency per week (P-value=0.88). Conclusion: Our study revealed that all of the patients undergoing hemodialysis in this center were faced CMV and they are at the risk of CMV infection, which may appear by virus reactivation through various stimuli such as immunosuppression, inflammation, etc. Therefore, it is necessary to screen these patients to prevent future consequences like renal transplant rejection and further transmission through hemodialysis machine.

Keywords:

CMV , Cytomegalovirus , Hemodialysis , Frequency