Hepatitis virus seroconversion among patients on maintenance hemodialysis in North India: a prospective cohort study

Objectives: Patients receiving hemodialysis (HD) are at increased risk of acquiring hepatitis B virus (HBV) and hepatitis C virus (HCV) due to repeated blood exposure, vascular access procedures, and blood transfusions. The study aimed to determine the seroconversion rates of HBV and HCV among patients undergoing dialysis and to identify associated risk factors. Methods: A total of 220 adult patients receiving dialysis who were seronegative for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies at baseline were enrolled. Serologic testing was repeated at 6 months. Results: Sixteen patients (7.3%) seroconverted to HBsAg positivity, and 23 (10.5%) seroconverted to anti-HCV positivity. HBV seroconversion was significantly associated with multiple dialysis center visits. HCV seroconversion was significantly associated with dialyzer reuse, multiple dialysis center visits, and dialysis duration ≥2 years. Elevated liver enzyme levels were strongly correlated with seroconversion for both viruses. Conclusion: HBV and HCV seroconversion remain concerns in HD units. Standardized infection control practices, minimization of patient transfers, and strict adherence to national guidelines are essential to reducing risk.