Occult hepatitis B virus infection in Egyptian hemodialysis patients with or without hepatitis C virus infection

Ismail, Hisham; Soliman, Mohamed; Ismail, Nahed

doi:10.2147/plmi.s12341

Cited by 21 publications

(8 citation statements)

References 25 publications

(35 reference statements)

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“…Considering HBV vaccination of high-risk groups in Iran since 2006, 10 this is possibly due to either a transient response or a low response to HBV vaccination in hemodialysis patients as a result of impaired immunity associated with chronic kidney disease. 38 Furthermore, levels of anti-HBsAb decline more rapidly in patients on maintenance hemodialysis compared with the general population. A double vaccine dose and a booster dose are therefore advised to maintain protective levels of anti-HBsAb in hemodialysis patients.…”

Section: Discussionmentioning

confidence: 99%

“…Because serum levels of aminotransferases tend to be reduced in patients on maintenance hemodialysis, it is difficult to recognize HBV-mediated liver disease by liver function tests in these patients. 5,38 Similarly, previous studies failed to report a relationship between serum aminotransferase levels and occult HBV infection in hemodialysis patients. 35,37 Moreover, HBV genotype D reported in this study is the main genotype in Iran 39 and is associated with progression to cirrhosis and hepatocellular carcinoma and worse disease outcomes.…”

Section: Discussionmentioning

confidence: 99%

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High Prevalence of Occult Hepatitis B Virus Infection among Iranian Hemodialysis Patients

Farshadpour

Taherkhani

Shahabi

2023

The American Journal of Tropical Medicine and Hygiene

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Considering the potential risks associated with occult hepatitis B virus (HBV) infection, this study was designed to investigate the magnitude and genotypic pattern of occult HBV infection among hemodialysis patients. All patients on regular hemodialysis attending the dialysis centers located in southern Iran and 277 nonhemodialysis controls were invited to participate in this study. Serum samples were tested for detection of hepatitis B core antibody (HBcAb) and hepatitis B surface antigen (HBsAg) by competitive enzyme immunoassay and sandwich ELISA, respectively. The molecular evaluation of HBV infection was conducted by two nested polymerase chain reaction (PCR) assays, targeting S, X, and precore regions of HBV genome, and sequencing by Sanger dideoxy sequencing technology. Moreover, HBV viremic samples were tested for hepatitis C virus (HCV) coinfection by HCV Ab ELISA and seminested reverse transcriptase PCR. Of 279 hemodialysis patients, five (1.8%) were positive for HBsAg, 66 (23.7%) were positive for HBcAb, and 32 (11.5%) had HBV viremia with HBV genotype D, sub-genotype D3 and subtype ayw2. Moreover, 90.6% of the hemodialysis patients with HBV viremia had occult HBV infection. Hemodialysis patients (11.5%) had significantly higher prevalence of HBV viremia than nonhemodialysis controls (1.08%; P = 0.0001). The prevalence of HBV viremia among hemodialysis patients was not statistically associated with duration of hemodialysis, age and gender distribution. In contrast, HBV viremia was significantly associated with place of residency and ethnicity, with residents of Dashtestan and Arab having had significantly higher prevalence of HBV viremia compared with the residents of other cities and Fars patients. Notably, 27.6% and 6.9% of hemodialysis patients infected with occult HBV infection were also positive for anti-HCV antibodies and HCV viremia, respectively. High prevalence of occult HBV infection was detected in hemodialysis patients, whereas 62% of patients with occult HBV infection were negative for HBcAb. Therefore, screening of all hemodialysis patients by sensitive molecular tests, regardless of the pattern of HBV serological markers, is recommended to increase the diagnosis rate of HBV infection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

High Prevalence of Occult Hepatitis B Virus Infection among Iranian Hemodialysis Patients

Farshadpour

Taherkhani

Shahabi

2023

The American Journal of Tropical Medicine and Hygiene

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“…According to Abu El Makarem et al and Ismail et al, patients on hemodialysis with and without chronic HCV infection did not show any significant differences in the prevalence of OBI [ 16 , 17 ]. Omar et al, El-Sherif et al, Mahmoud et al, and Selim et al showed that liver aminotransferases were statistically higher in patients with dual OBI/HCV infection than those with mono-HCV infection [ 31 , 33 – 35 ], which is consistent with other studies [ 83 – 85 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of occult hepatitis B virus infection in Egypt: a systematic review with meta-analysis

Azzam,

Khaled,

El-kayal

et al. 2023

J. Egypt. Public. Health. Assoc.

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Background Occult hepatitis B virus (HBV) infection (OBI) is a major public health problem. The clinical importance of OBI stems from the fact that it can be transmitted to healthy individuals at extremely low viral load levels. Additionally, immunosuppression has the potential to trigger viral replication, which can result in life-threatening liver decompensation. Despite several studies examining the prevalence of OBI, the pooled prevalence of OBI in Egypt remains unknown, particularly among blood donors and high-risk individuals, to whom intervention should be targeted. Methods A comprehensive literature search of the following databases was conducted from inception to October 2022 using the following keywords: occult hepatitis B virus infection or occult HBV infection or OBI and Egypt in MEDLINE [PubMed], Scopus, Google Scholar, and Web of Science. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. I-squared and Cochran’s Q were used to measure the heterogeneity between the studies, and based on the random effects model, results were reported as proportions (%) with a 95% confidence interval (CI). Analyses of subgroup analyses were conducted based on the target population. Sensitivity analyses were conducted using the leave-one-out approach to test the robustness of the results. Results A total of 50 studies with 62 estimations of OBI were included, 19 in patients who were HBsAg-negative and anti-HBc-positive and 43 in patients who were HBsAg-negative. The highest prevalence (41%) was among multi-transfused patients according to studies that report occult hepatitis B virus prevalence in an HBsAg-negative population, while the pooled prevalence of OBI among patients on hemodialysis, patients with chronic hepatitis C infection, patients with hepatocellular carcinoma (HCC), and patients with liver cirrhosis was 17%, 10%, 24%, and 13%, respectively. On the other hand, among studies that report OBI prevalence in HBsAg-negative and anti-HBc-positive individuals, the pooled prevalence of OBI among blood donors, patients with chronic hepatitis C infection, and patients with HCC was 12%, 15%, and 31%, respectively. Also, the majority of studies examining the genetic background of OBI have found that genotype D is the most prevalent. Conclusion This study highlights the high prevalence in OBI among blood donors and high-risk populations in Egypt. The implementation of HBV nucleic acid amplification testing (NAT) may increase the safety of blood transfusions by excluding all HBV DNA-positive donations. However, the cost-effectiveness of these tests should be investigated.

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“…The discrepancy in the reported incidences of occult HBV infection between several studies, including that of this study, could be due to several factors. It could be attributed to difference in the sensitivity of the various molecular biology techniques used in detection of HBV DNA, differences in the prevalence of HBV in geographical area, and differences in the storage and age of serum samples used in studies (Hisham et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of occult hepatitis B virus (HBV) infections in haemodialysis patients in Khartoum State, Sudan from 2012 to 2014

Mohammed¹,

Enan²,

Khair³

et al. 2015

J. Med. Lab. Diagn.

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This study was carried out to detect occult hepatitis B virus (OHB) among haemodylsis patient inKhartoum State, Sudan. Antigen capture enzyme linked immunosorbent assay (ELISA) to detect hepatitis B surface antigen (HBsAg), competitive ELISA to detect Hepatitis B core antibody (HBcAb) antibodies and polymerase chain reaction (PCR) to detect hepatitis B virus (HBV) DNA were used to analyze 100 plasma samples collected from patients in 3 hospitals (El Amel Hospital, Bashair Hospital and Salma Hospital) during the period of 2012 to 2014. Out of the patient sampled, 65 were males and 35 were females (age 18 to 70 years) none of these patients showed signs of clinical hepatitis. The results showed that 9 out of the 100 samples were positive for HBsAg, and were subsequently excluded from the study. Out of the remaining HBsAg negative 91 samples, 38(51.6%) showed positive HBc antibodies and 3 (3.3%) tested positive to HBV DNA using competitive ELISA and PCR, respectively. These results indicated that molecular detection of occult HBV infections in haemodialysis patients in Sudan is of fundamental importance to prevent HBV transmission through contamination of heamodialysis machines.

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Occult hepatitis B virus infection in Egyptian hemodialysis patients with or without hepatitis C virus infection

Cited by 21 publications

References 25 publications

High Prevalence of Occult Hepatitis B Virus Infection among Iranian Hemodialysis Patients

High Prevalence of Occult Hepatitis B Virus Infection among Iranian Hemodialysis Patients

Prevalence of occult hepatitis B virus infection in Egypt: a systematic review with meta-analysis

Prevalence of occult hepatitis B virus (HBV) infections in haemodialysis patients in Khartoum State, Sudan from 2012 to 2014

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