Occult hepatitis B virus infection in dialysis patients: a multicentre survey
Article first published online: 2 JUN 2005
Alimentary Pharmacology & Therapeutics
Volume 21, Issue 11, pages 1341–1347, June 2005
How to Cite
Fabrizi, F., Messa, P. G., Lunghi, G., Aucella, F., Bisegna, S., Mangano, S., Villa, M., Barbisoni, F., Rusconi, E. and Martin, P. (2005), Occult hepatitis B virus infection in dialysis patients: a multicentre survey. Alimentary Pharmacology & Therapeutics, 21: 1341–1347. doi: 10.1111/j.1365-2036.2005.02501.x
- Issue published online: 2 JUN 2005
- Article first published online: 2 JUN 2005
- Accepted for publication 30 March 2005
Background : The epidemiology and clinical significance of occult hepatitis B virus infection (serum hepatitis B surface antigen-negative patients with detectable hepatitis B virus viraemia in serum) remains controversial with only limited information about its prevalence in patients on long-term dialysis.
Aim : To address the epidemiology of occult HBV infection in a large cohort of dialysis patients.
Methods : We screened a large cohort (n = 585) of Italian chronic dialysis patients; from this population, a group of hepatitis B virus surface antigen seronegative patients (n = 213) was tested by Amplicor hepatitis B virus Monitor Test to detect hepatitis B virus viraemia (hepatitis B virus-DNA) in serum.
Results : Occult hepatitis B virus infection was absent (zero of 213 = 0%). Persistent hepatitis B virus surface antigen carriage was less frequent than anti-hepatitis B virus core antibody (anti-hepatitis B core antigen) seropositive status in this study group [1.88% (11 of 585) vs. 36% (216 of 585), P = 0.0001]. No dialysis patients seropositive for anti-hepatitis B core antibody in serum (zero of 123 = 0%) had detectable hepatitis B virus-DNA by polymerase chain reaction technology. No significant association between abnormal biochemical liver tests and serum anti-hepatitis B core antibody was noted in our population. Nominal logistic regression analysis demonstrated an independent and significant relationship between anti-HCV antibody and anti-hepatitis B virus core antibody in serum (Wald chi-square 16.06, P = 0.0001). The rate of seropositive patients for anti-hepatitis B virus core antibody was higher among study patients than controls with normal renal function [36.9% (216 of 585) vs. 21.4% (59 of 275), P = 0.0001]; this difference partially persisted after correction for demographic parameters, and viral markers.
Conclusion : In conclusion, occult hepatitis B virus was absent in our study group. Anti-hepatitis B core antibody was significantly related to presence of anti-HCV antibody supporting shared modes of transmission. Clinical studies based on molecular biology techniques provided with higher sensitivity are planned.