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

<b>Background</b><b> and aims</b><b>:</b> 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.<br /> <b>Methods:</b>  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.<br /> <b>Results:</b> 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%).<br /> <b>Conclusions:</b> 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