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Article Investigation of Hepatitis E Virus Seroprevalence and Risk Factors in Hemodialysis Patients(Frontiers Media Sa, 2025) Ozturk, Hakki; Ozsoy, Metin; Tuna, Aysegul; Varlibas, Artuner; Cesur, Salih; Aksoy, Altan; Demir, Mehmet EminBackground: Hemodialysis patients are at increased risk for hepatitis E virus (HEV) infection due to their immunocompromised status and frequent exposure to invasive medical procedures. HEV can lead to chronic infections and severe complications, particularly in high-risk populations. This study aimed to determine HEV-IgG seroprevalence among hemodialysis patients in Ankara, Turkey, and evaluate associated risk factors. Methods: A total of 160 hemodialysis patients from three private dialysis centers in Ankara were included in this prospective, cross-sectional study. Anti-HEV-IgG antibodies were detected using the ELISA method. Demographic characteristics and potential risk factors, including dialysis duration, comorbidities, blood transfusion history, drinking water source, dietary habits, and involvement in animal husbandry, were assessed via structured surveys. Statistical analyses were conducted using SPSS Version 22.0, with Pearson's chi-square and Fisher's exact tests applied to categorical variables. Logistic regression analysis was performed to identify independent risk factors for HEV seropositivity. Results: HEV-IgG seropositivity was detected in 42 patients (26.25%). Seroprevalence increased significantly with age, rising from 6.7% in patients under 55 years to 47.4% in those over 65 years (p < 0.001). Extended dialysis duration (>5 years) was also significantly associated with HEV seropositivity (p = 0.02). However, no significant associations were found between HEV seropositivity and gender, blood transfusion history, source of drinking water, consumption of raw meat, or involvement in animal husbandry (p > 0.05). Conclusion: The HEV-IgG seroprevalence among hemodialysis patients in Ankara was higher than previously reported rates in Turkey. Age and prolonged dialysis duration emerged as significant risk factors, underscoring the importance of screening and preventive strategies in this vulnerable population. Further multi-regional studies are needed to better understand HEV transmission dynamics and improve management strategies in hemodialysis patients.Article Evaluation of Anti-Tetanus IgG Antibody Levels and Influencing Factors in Patients Undergoing Hemodialysis(Frontiers Media Sa, 2025) Ozsoy, Metin; Ozturk, Hakki; Tuna, Aysegul; Varlibas, Artuner; Cesur, Salih; Aksoy, Altan; Demir, Mehmet EminAim: This study aimed to assess anti-tetanus IgG antibody levels and identify determinants of inadequate tetanus immunity among maintenance hemodialysis (HD) patients. Methods: In this cross-sectional study, anti-tetanus IgG levels were measured by quantitative ELISA in 162 adult HD patients from two dialysis centers in Ankara, Turkey. Protective immunity was evaluated using both international (>= 0.1 IU/mL) and robust (>= 0.5 IU/mL) cut-offs. Demographic and clinical factors associated with immunity were analyzed by multivariate logistic regression. Results: Only 16.7% of HD patients achieved robust protection (>= 0.5 IU/mL), whereas 49.8% had minimal protection (>= 0.1 IU/mL). Protective immunity was independently associated with younger age (OR 1.07 per year; p = 0.004), shorter dialysis duration (OR 1.07; p = 0.030), male sex (female OR 2.92; p = 0.048), and recent booster vaccination within 10 years (OR 0.11; p < 0.001). Diabetes mellitus was not an independent factor. Conclusion: Most HD patients lacked durable tetanus immunity, particularly older females on long-term dialysis. The findings highlight the need for regular antibody monitoring, early revaccination, and structured booster programs to maintain adequate protection in this high-risk population.
