Spontaneous Clearance of Hepatitis B Surface Antigenemia in a Hemodialysis Patient

Abstract

The incidence of hepatitis B has been reported to be high in dialysis centers. Dialysis patients are at increased risk of acquiring hepatitis B due to their immunodeficient state, which impairs elimination of the hepatitis B virus; chronic dialysis patients rarely clear hepatitis B surface antigen (HBsAg) spontaneously. Hepatitis B virus infection is associated with a high risk of hepatic complications. We report the case of a 66-year-old HBsAg-positive female patient who had undergone hemodialysis for 58 months due to end-stage renal failure and became HBsAg-negative followed by the development of hepatitis B surface antibody.

Spontaneous Negative Seroconversion of Both Hepatitis B and C in an Egyptian HD Patient

“…Surprisingly, the patient of the current case presentation has also been cleared from hepatitis B virus, and has become negative for HBsAg and developed hepatitis B surface antibodies by ELISA testing, after 13 years on HD. This finding is in contradiction to the well-known belief that spontaneous hepatitis B clearance rarely happens in hemodialysis patients, owing to their immunodeficient state [21]. However, some authors Jeon and Ha [21]; Patel [22] published a few cases reports documenting hepatitis BV clearance followed by the development of hepatitis B surface antibodies, years after starting HD.…”

“…This finding is in contradiction to the well-known belief that spontaneous hepatitis B clearance rarely happens in hemodialysis patients, owing to their immunodeficient state [21]. However, some authors Jeon and Ha [21]; Patel [22] published a few cases reports documenting hepatitis BV clearance followed by the development of hepatitis B surface antibodies, years after starting HD. The latter authors ascribed this clearance to the potential immunopotentiation that could have occurred with long-term HD.…”