Low HBV‐DNA levels in end‐stage renal disease patients with HBeAg‐negative chronic hepatitis B

Abstract

In end-stage renal disease patients treated by hemodialysis with HBeAg-negative chronic hepatitis B virus (HBV) infection, the evaluation of the presence of viral replication is essential in the assessment for renal transplantation. Data on HBV viral load, prevalence of precore mutations, as well as the influence of HCV coinfection on HBV-DNA levels in this group of patients is scarce. The aim of this study was to determine the HBV viral load in HBsAg-positive/HBeAg-negative hemodialysis patients; to compare HBV-DNA levels between isolated HBV infection carriers and HBV-HCV coinfected patients, and to evaluate the prevalence of precore mutations in these patients. Fifty hemodialysis patients with chronic HBeAg-negative HBV infection were studied. Viral load was determined by PCR (Amplicor HBV Monitor-Roche). The detection of precore mutations was made by sequencing. Of a total of 50 patients, 76% were male, with a mean age of 44 +/- 11 years. Anti-HCV was positive in 56% of patients. HBV-DNA was undetectable in 58% of patients; 24% had HBV-DNA <10,000 copies/ml, 12% between 10,000-100,000 copies/ml, and only 6% had HBV-DNA >100,000 copies/ml. There was no difference in the viral load of patients infected only by HBV and HBV-HCV co-infected patients (P = 0.96). Precore mutations were detected in only 8% of cases. In conclusion, hemodialysis patients with HBeAg-negative HBV infection had a low viral load. Precore mutations were infrequent and the presence of anti-HCV has not influenced the levels of HBV-DNA.

Hepatitis B Virus Infection Profile in Different Hemodialysis Units in Recife, Pernambuco, Brazil

“…The ideal would be to carry out monitoring through investigating HBeAg and HBV DNA in these patients to assess level of active viral replication. The results founds corroborated with literature which showed HBsAg seropositivity in hemodialysis patients without detectable serum HBV DNA were 11.8% to 58% (Teles et al 1998, Fabrizi et al 2003, Souza et al 2003, Ferreira et al 2006, Moutinho et al 2006). …”

Kinetics of hepatitis B virus load and haemodialysis: a prospective study

“…The available information suggests slow progression of HBV‐related liver disease in the dialysis population, and various mechanisms have been cited to explain this; the virological features of HBV could play a pivotal role in this respect. Preliminary data have shown that the viral load in chronic HBsAg‐positive carriers on maintenance dialysis is low and stable over time despite the immunodeficiency related to chronic uraemia [24,25]. The first goal of this study was to show that haemodialysis per se leads to a reduction in HBV viraemia; this phenomenon occurs irrespective of patient (or dialysis) characteristics or type of dialysis membranes.…”

Hepatitis B Virus Infection and the Dialysis Patient

“…It appears that the HBV viral load in these patients tends to be low and stable over time. The frequency of HBsAg seropositivity in dialysis patients without detectable serum HBV DNA is between 14% and 58% in published series (27,28). Moutinho et al.…”

“…Moutinho et al. observed high HBV DNA levels (>100,000 copies/ml) in only 6% of their population ( n = 50) (28).…”