Antibodies to Core Antigen of Hepatitis B Virus in Patients on Renal Replacement Therapy: Association with Demographic, Clinical and Laboratory Data

Abstract

Background: Total antibodies to core antigen of hepatitis B virus (anti-HBc) are a marker for previous or current infection with hepatitis B virus (HBV). Our aim was to examine the prevalence and incidence of anti-HBc in relation to demographic, clinical and laboratory data of patients treated with intermittent hemodialysis (IHD). Methods: Predictors for anti-HBc positivity were evaluated in prevalence IHD patients with negative testing for surface antigen of HBV (HBsAg, n = 1,105) using the stepwise backward regression analysis. Patients starting IHD (n = 336) were introduced into the one-year prospective study evaluating seroconversion for anti-HBc. Results: Anti-HBc positivity (19.5% of all patients) was predicted by lack of vaccination against HBV with developed protective titer of antibodies to HBsAg (β = 0.592, p = 0.000), vintage of renal replacement therapy (RRT, β = 0.206, p = 0.000), history of hepatitis (β = 0.101, p = 0.000), and activity of alanine aminotransferase (β = 0.057, p = 0.037). In 85 prospective patients who finished first IHD year, seroconversion rate for anti-HBc was 1.23 episodes/100 patient-years. Conclusions: Lack of or not effective vaccination against HBV is the strongest predictor for prevalence of anti-HBc positivity in RRT patients. Periodical determination of anti-HBc, usually not required, may be helpful in evaluation of current epidemiological status and risk for further HBV infection in dialysis centers.

Titers of antibodies to the surface antigen of hepatitis B virus after vaccination in relation to immunity-related gene variants. A prospective study among hemodialysis patients

“…DISCUSSION According to recent studies, 21,22 approximately 80% of HD patients respond to HBV vaccination. The response rate of 88.1% obtained in our cohort was slightly higher, but we should allow for the fact that our patients were IL12A rs568408 than in those of 1 or 2 minor alleles (a dominant model of inheritance; FIGURE 4).…”

Hepatitis B Vaccination in Chronic Kidney Disease: Review of Evidence in Non-Dialyzed Patients

“…In dialysis patients, the loss of hepatitis B immunity seems to be quicker than in healthy subjects (10, 16, 18). Ineffective vaccination is predictive for prevalence and incidence of HBsAg positivity (4) and anti-HBc positivity (7, 20). At present, the attention of nephrologists is focused on CKD patients, who are currently non-dialyzed, but as their kidney disease progresses, it is likely to lead to RRT in the future.…”

Antibodies to hepatitis B virus surface antigen and interleukin 12 and interleukin 18 gene polymorphisms in hemodialysis patients

“…As shown in this study, HBsAg carriers amounted for 3.1% of all HD patients and isolated anti-HBc positivity occurred in 13.3% of the anti-HBc positive HD patients. As such frequencies are in the medium range [26,29-31], these results indicate thousands of affected HD people worldwide.…”