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Pranto, Alif Hasan, Suez, Ehsan, Uddin, Md Ekhtiar, Tonmoy, Hasan Shahriyer, Meem, M. M. Rubaiyat Muntasir, Montasir, Fahim, Nourin, Farzana, Ahmed, Farhana, Abir, Shifaty Nur, Islam, Dewan Zubaer, Ajmal, Muhammed, Begum, Rahima and Khandker, Shahad Saif (2026) Global epidemiology of hepatitis B virus infection in dialysis patients: a systematic review and meta-analysis of prevalence, immunity, risk factors, and beyond. International urology and nephrology. ISSN 1573-2584
Hepatitis B infection is a global threat caused by the Hepatitis B virus (HBV), which can be transmitted through blood transfusions. Again, dialysis is a mechanical process that is used to filter the blood of patients with chronic kidney disease (CKD). In this study, we aimed to evaluate the worldwide prevalence of HBV infection using primary published data on hepatitis B virus surface antigen (HBsAg) and HBV-DNA prevalence among dialysis patients. To obtain the data, we searched three different online databases, and from 479 studies, 79 articles were selected for this study. Besides prevalence analysis, study outliers, quality, and characteristics were identified as well. We found the pooled prevalence of HBsAg and HBV-DNA to be 7.0% (95%CI: 6.1-8.0) and 1.5% (95%CI: 1.0-1.9), respectively, although, excluding the outliers, the prevalence of HBsAg became 6.3%, but HBV-DNA remained the same. Besides, we determined that 49.2% (95%CI: 30.2-68.1) of dialysis patients took the HBV vaccine, and 40.0% (95%CI: 31.1-48.8) of patients developed natural immunity (anti-HBV antibody). Among continent-based analyses, Australia was determined to have the highest prevalence of HBsAg (8.7%), and Asia and Africa were found to have the same and highest prevalence of HBV-DNA (4.1%). Among risk factors, blood transfusion was the highest, followed by duration of dialysis, HCV/other infections, renal diseases, and so on. This study indicates the importance of careful and contamination risk-free dialysis among patients, vaccination, and early diagnosis of HBV to avoid and prevent the risk of HBV infection. [Abstract copyright: © 2026. The Author(s), under exclusive licence to Springer Nature B.V.]
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