Recurrence and clearance of hepatitis B surface antigenemia in a dialysis patient infected with the human immunodeficiency virus

• Published in: American journal of kidney diseases Vol. 16; no. 2; p. 154
• Main Authors: Ortiz-Interian, C J, de Medina, M D, Perez, G O, Bourgoignie, J J, Watkins, F, Velez-Robinson, E, Schiff, E
• Format: Journal Article
• Language: English
• Published: United States 01.08.1990
• Subjects: Acquired Immunodeficiency Syndrome - complications; Adult; Hepatitis B - complications; Hepatitis B Surface Antigens - analysis; HIV-1; Humans; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - therapy; Male; Recurrence; Renal Dialysis
• ISSN: 0272-6386
• DOI: 10.1016/S0272-6386(12)80571-3

Hepatitis B vaccination programs have prevented infection in many dialysis patients, although the antibody response to vaccination is still insufficient in approximately 50%. Reinfection or reactivation of latent hepatitis B infection (HBV) has been reported in certain groups of immunosuppressed patients, including those infected with the human immunodeficiency virus (HIV-1). We report the reactivation or reinfection of HBV with resurgence of hepatitis B surface antigen in a dialysis patient coinfected with HIV-1. Thus, in dialysis patients with latent HBV infection, with undetectable hepatitis B surface antigen (HBsAg) levels, the potential exists to reactivate during immunosuppression associated with HIV-1 infection and/or end-stage renal disease. Reinfection with a different subtype is also possible. The development of hepatitis B surface antigenemia in this patient population creates a potential for transmission in the dialysis setting. This is of special concern since the number of patients infected with HIV-1 and with evidence of prior hepatitis B infection is increasing in urban units.