Prevalence of Occult Hepatitis B Virus Infection in Hemodialysis Patients

Yoo, Jeong Hwan; Hwang, Seong Gyu; Yang, Dong Ho; Son, Myung Su; Kwon, Chang-Il; Ko, Kwang Hyun; Hong, Sung Pyo; Park, Pil Won; Rim, Kyu Sung

doi:10.4166/kjg.2013.61.4.209

Cited by 20 publications

(15 citation statements)

References 22 publications

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“…Occult HBV infection was detected in 32 of the 100 patients on chronic hemodialysis therapy, and all of these patients were anti-HBc positive. The frequency of occult infection among the hemodialysis patients studied verifies previous findings [23][24][25][26]. Although, a lower prevalence was reported previously [27], and Goral et al [28] reported that occult HBV was absent in their hemodialysis patients.…”

Section: Discussionsupporting

confidence: 89%

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Occult hepatitis B virus infection among chronic hemodialysis patients in Alexandria, Egypt

Helaly¹,

Ghazzawi²,

Shawky³

et al. 2015

Journal of Infection and Public Health

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The prevalence of end-stage renal disease has increased dramatically in developing countries. Hepatitis B virus (HBV) infection is a global health problem that represents a significant co-morbidity event that has led to outbreaks of hepatitis B. There are inadequate data concerning occult HBV infection among Egyptian chronic hemodialysis patients. This study aimed to detect occult HBV infection among chronic hemodialysis patients in Alexandria, Egypt. A cross-sectional study was performed on 100 patients with end-stage renal disease that received maintenance hemodialysis and had tested negative for HBV surface antigen. Blood samples were collected before the initiation of hemodialysis. Sera were tested for hepatitis C virus (HCV) and hepatitis B core (HBc) antibodies using ELISA, and HBV DNA was detected by SYBR Green real-time PCR using specific primers for the s and c genes and by nested PCR using pol gene-specific primers. The serum activity of alanine and aspartate aminotransferase (ALT and AST) were also measured. Anti-HCV and anti-HBc antibodies were detected in 34% and 48% of patients, respectively, and 70.6% of anti-HCV positive patients were also positive for anti-HBc antibodies. This association was statistically significant (p=0.001). HBV DNA was detected in 32% of the hemodialysis patients. A significant association was determined between the presence of HBV DNA and anti-HCV positivity (p=0.021). Aminotransferases were elevated in 21% of the studied patients, more often in patients with positive anti-HCV profiles than in patients negative for anti-HCV (p<0.05). In conclusion, the serological markers of HBV infection should be verified with molecular tests to investigate possible occult infections, especially among anti-HBc-positive hemodialysis patients, to improve our understanding of their clinical, laboratory, and epidemiological characteristics.

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Section: Discussionsupporting

confidence: 89%

“…In Italy, the prevalence ranged from 0% in a cohort of 213 dialysis patients [8] to 26.6% in another cohort [9], while in Turkey, prevalence rates up to 12.4% [10] have been recorded. A previous study carried out in Egypt reported a prevalence of 5.2% occult HBV in hemodialysis patients [11].…”

Section: Introductionmentioning

confidence: 99%

Occult hepatitis B virus infection among chronic hemodialysis patients in Alexandria, Egypt

Helaly¹,

Ghazzawi²,

Shawky³

et al. 2015

Journal of Infection and Public Health

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“…Many studies confirm a relatively high frequency of occult hepatitis B viral infection in hemodialysed patients [2] [19] Hepatocellular carcinoma (HCC) [20] No case of HCC was noted in our study on condition of the anatomo-pathologic test which was not carried out in our patients. The occult hepatitis B viral infection prevalence varies from 10% -60% and even more in case of HCC with unknown aetiology [1].…”

Section: Occult Hepatitis B Viral Infection In Hemodialysed Patientsmentioning

confidence: 80%

Hepatitis B Surface Antigen Should Not Be the Only Sought Marker to Distinguish Blood Donors towards Hepatitis B Virus Infection in High Prevalence Area

Somda¹,

Sermé²,

Coulibaly³

et al. 2016

OJGas

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Since its discovery by Blumberg in 1965, the hepatitis B surface antigen (HBsAg) is used as the fingerprint of hepatitis B infection. Occult hepatitis B infection (OBI) is defined by a viral replication (DNA detectable) in the absence of HBsAg. Burkina Faso is a high endemic area where the prevalence is higher than 14%. At the National Center for Blood Transfusion (NCBT) of Ouagadougou, HBsAg is the only sought marker used to distinguish donors towards Hepatitis B Virus (HBV). Acceptation of blood donation is based specifically on the absence of HBsAg, which exposes to the risk of HBV transmission during transfusion. The goal of this study is to evaluate this risk by determining the prevalence of OBI in blood donors. Patients and Methods: It was a five-month prospective study on blood donations collected from January to May 2016. The HBc antibody has been sought in the serums of negative HBsAg donors. The measure of B DNA by Real Time PCR (polymerase chain reaction) and that of antibodies anti-HBs have been proposed to anti-HBc positive donors. Abdominal ultrasound, the transaminases, prothrombin level, alphafeto-proteins, hepatic fibrosis have been proposed to donors who were detectable for the DNA. Sociodemographic parameters have been collected. The test costs were borne by donors who were recalled by phone to adhere to the study. Results: Among 1980 negative donors HBsAg, 872 (44%) were positive for anti-HBc. 160 on 872 donors were received for consultation, among which 76 (76/160) were able to realise DNA which was detectable in 25 donors on 76, thus a prevalence of 32.8%. The mean value of DNA was 953 IU/ml. Physical examination and hepatic ultrasounds were normal except a case where hepatic steatosis was found. The biologic standard hepatic results were in normal range. None of the patient was able to realise hepatic fibrosis evaluation. A case of co-infection HIV/OBI was noted. Conclusion: This study shows that in BurHow to cite this paper: Somda, K.S., Sermé, A.K., Coulibaly, A., Cissé, K., Sawadogo, A., Sombié, A.R. and Bougouma, A. 363kina, almost half of blood bags transfused are anti-HBc positive and around one third (32.8%) probably have HBV DNA. This poses a potential risk of contamination for non-immunized recipient. It is thus important that, in addition to HBsAg, AntiHBc should be systematically sought in order to minimize the risk.

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“…Marked variation was found by comparing these rates with OBI prevalence rates reported in other related national or international studies (23) (24) (35) (36) (37) (38) (39) .This variation may be attributed to differences in the sample size of the study populations, demographics, immunologic status of the studied patients, endemicity of HBV infection, levels of viral DNA in the blood, sampling conditions and the types of diagnostic tool(s) used for diagnosis (40) . This comparison also revealed that the prevalence of OBI in our target HD patients was relatively low, possibly due to the application of safety precautions during the dialysis process in these units and the implementation of the routine vaccination program.…”

Section: Discussionmentioning

confidence: 99%

Occult HBV infection status among chronic hepatitis C and hemodialysis patients in Northeastern Egypt: regional and national overview

Mandour

Nemr

Shehata

et al. 2015

Rev. Soc. Bras. Med. Trop.

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Introduction:Occult hepatitis B infection (OBI) is considered to be one of the major risks for patients suffering from end-stage renal disease (ESRD) on regular hemodialysis (HD) and patients with chronic hepatitis C virus (HCV) infection. This study compared the prevalence of OBI among these two high-risk groups in the Suez Canal region, Northeastern Egypt, to obtain a better national overview of the magnitude of OBI in this region. Methods: Serum samples were collected from 165 HD patients and 210 chronic HCV-infected patients. Anti-HCV antibody, hepatitis B surface antigen (HBsAg), total hepatitis B core (anti-HBc) antibody, and hepatitis B surface antibody (anti-HBs) were detected by enzyme-linked immunosorbent assay (ELISA). HCV RNA was detected using a quantitative real-time RT-PCR assay, and HBV was detected using a nested PCR. Results: All patients were negative for HBsAg. A total of 49.1% and 25.2% of the patients in the HD and HCV groups, respectively, were anti-HBc-positive. In addition, more anti-HBs-positive patients were detected in the HD group compared to the HCV group (52.1% and 11.4%, respectively). Three cases were positive for HBV DNA in the HD group, while eighteen positive cases were detected in the HCV group. Both study groups showed signifi cant differences in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level as well as anti-HBc, anti-HBs and HBV-DNA positivity. Conclusions: OBI was more prevalent among chronic HCV patients than HD patients in the Suez Canal region, Egypt, with rates of 8.5% and 1.8%, respectively. However, more precise assessment of this infection requires regular patient follow-up using HBV DNA detection methods.

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Prevalence of Occult Hepatitis B Virus Infection in Hemodialysis Patients

Cited by 20 publications

References 22 publications

Occult hepatitis B virus infection among chronic hemodialysis patients in Alexandria, Egypt

Occult hepatitis B virus infection among chronic hemodialysis patients in Alexandria, Egypt

Hepatitis B Surface Antigen Should Not Be the Only Sought Marker to Distinguish Blood Donors towards Hepatitis B Virus Infection in High Prevalence Area

Occult HBV infection status among chronic hepatitis C and hemodialysis patients in Northeastern Egypt: regional and national overview

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