Occult hepatitis B virus infection in dialysis patients: a multicentre survey

• Published in: Alimentary pharmacology & therapeutics Vol. 21; no. 11; pp. 1341 - 1347
• Main Authors: Fabrizi, F., Messa, P. G., Lunghi, G., Aucella, F., Bisegna, S., Mangano, S., Villa, M., Barbisoni, F., Rusconi, E., Martin, P.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.06.2005; Blackwell
• Subjects: Biological and medical sciences; Case-Control Studies; Cohort Studies; Digestive system; Female; Gastroenterology. Liver. Pancreas. Abdomen; Hepatitis B Antibodies - blood; Hepatitis B Core Antigens - blood; Hepatitis B, Chronic - blood; Hepatitis B, Chronic - epidemiology; Humans; Italy - epidemiology; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Regression Analysis; Renal Dialysis - statistics & numerical data; Italy; Infection; Human; Viral hepatitis B; Survey; Viral disease; Digestive diseases; Hepatic disease; Dialysis
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2005.02501.x

Summary 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.