Hepatitis and haemodialysis

What is hepatitis?

Hepatitis is a term that means inflammation of the liver. The most common causes of hepatitis are viral infections known as hepatitis B and hepatitis C.

What are the symptoms of hepatitis?

hepatitis B

For some, infection may cause no symptoms at all initially. Others experience a short ‘flu-like illness often accompanied by jaundice (yellowing of the skin and the whites of the eyes) and dark urine.

hepatitis C

It is common for people with hepatitis C to have no symptoms at all. A person with the virus may not know it for years. Some people do experience symptoms. These might include ‘flu-like symptoms and jaundice.

How do people get hepatitis?

It is very important to emphasise that you cannot catch hepatitis B or C by everyday social contact such as kissing, hugging, shaking hands, sharing food, cups, crockery or towels, by coughing or sneezing. Nor can you catch it from toilet seats. the next 2 paragraphs will tell you the main ways that the viruses are spread

hepatitis B

There are two main ways to catch hepatitis B, through sexual intercourse with an infected person or through contact with the blood of an infected person for example, sharing needles and syringes with an infected intravenous drug user.

hepatitis C

Hepatitis C is spread mostly by contact with the blood of an infected person. The chances of catching it through sexual intercourse or any other way are low. Unfortunately, before proper screening was introduced and before EPO appeared when blood transfusions were required to treat anaemia some dialysis patients were infected.

What happens if you have hepatitis B or C?

In both hepatitis B and C many people will recover from the virus and no trace of the virus will be found in their blood. Unfortunately, others will continue to have hepatitis virus in their blood. This means that they can spread the disease to others and that they may develop, in the future, liver damage.

How is the risk of catching hepatitis reduced in dialysis units?

Because hepatitis B and C are passed from one person to another through contact with an infected person’s blood, dialysis units take the following special precautions to ensure that the chances of one person catching these viruses from another are very small:

  • staff practice universal precautions, using gloves, gowns and even masks to ensure that the risk of spreading any blood borne disease is minimised.
  • machines are carefully cleansed and disinfected between users,
  • patients who are known to have hepatitis or any other blood borne virus and those whose status is not known receive their dialysis in a separate area.
  • following Renal Association guidelines a testing programme for these viruses is in operation. All dialysis patients are checked every 3 months for hepatitis B and every 6 months for hepatitis C.

As already noted, the chances of catching hepatitis B or C through dialysis is very, very, small indeed.

Is there a vaccination for hepatitis?

A vaccine does exist for hepatitis B, although the success rate is low leaving about a third of patients without protection. For this reason and because of the very low levels of hepatitis B in the dialysis patient population it is not yet clear if the vaccination of all patients should proceed. However, the Renal Association has recommended that, ideally, all patients should be vaccinated before they start haemodialysis. It has also recommended that patients on dialysis should be immunised and given regular boosters as necessary.

Patients exposed to hepatitis B may also receive vaccination in order to boost their immune system response to the virus.

There is no vaccination for hepatitis C.

If you need further information on hepatitis B and C you should discuss it with your doctor and/or the nursing staff at your dialysis unit.

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