Hepatitis B Virus Infection in Dialysis Patients

Fabrizi, Fabrizio; Martin, Paul

doi:10.1159/000013548

Cited by 51 publications

(56 citation statements)

References 90 publications

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“…[1][2][3][4] It is thought that liver injury associated with HBV infection is mediated by both viral factors and host immune response. [1,5] However, cellular immunity is often depressed in the uremic patients, [5][6][7][8] raising the question of why the clinical outcome of HBV infection in HD patients is different from that in the general population. On the other hand, is the viral factor of the uremic patients different from the general population?…”

Section: Discussionmentioning

confidence: 99%

“…Because long-term HD may result in hypoaminotransferasemia, [5][6][7][8] it is unclear whether or not many HBVinfected uremic patients under HD have latent liver injury. Further study of the role of HBV infection on the liver damage in such patients is needed.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] A revised cutoff value of ALT (17 IU/L) for the uremic patients had been described previously.…”

Section: Definition Of High Alt Levelmentioning

confidence: 99%

“…[1][2][3][4] However, the natural course of hepatitis B virus (HBV) infection of the uremic patients remains unclear. [5][6][7][8][9][10][11] Recently, the REVEAL-HBV study from Taiwan demonstrate that an elevated viral load, serum HBV DNA level, is a strong risk factor predicting HCC and liver cirrhosis in HBV carrier. [12,13] As a few studies report, uremic patients with HBV infection usually have a low viral load.…”

Section: Introductionmentioning

confidence: 99%

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Hemodialysis Reduces the Viral Load in Uremic Patients with Chronic Hepatitis B Infection

et al. 2008

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Background and aims. The effect of hemodialysis (HD) to change the viral load of hepatitis B virus (HBV) in uremic patients with chronic HBV infection has never been studied. In this study, we investigated the HBV viral loads and their changes between the HD procedure in the uremic patients. Patients and methods. A total of 38 chronic HBV-infected uremic patients were enrolled, but eight cases were excluded due to HCV co-infection and under anti-viral therapy. To evaluate the HBV DNA levels and their changes through the course of HD, we quantified serial serum samples from each patient immediately before HD, at the end of HD, and 48 hours later-immediately before the next HD. Results. Most of our HBV-infected uremic patients had a relatively lower HBV viral load; 80% cases with HBV DNA Ϲ4 Log 10 copies/mL, in comparison with the Taiwan epidemiologic study for community base HBV carriers. There was no significant difference of HBV DNA level between HBeAg-positive and -negative patients, but a significant higher DNA level in the high ALT group (p = 0.029) and liver cirrhosis patients (p = 0.002). The mean HBV DNA levels, before and after HD, respectively, in our 30 patients were 3.823 ± 1.130 Log 10 copies/mL and 3.686 ± 1.114 Log 10 copies/mL. It was a significant decrease on HBV DNA level in chronic HBV-infected patients through HD procedure (p = 0.004). The mean HBV DNA level of two days after HD was 3.702 ± 1.094 Log 10 copies/ mL, which was not significantly different from the HBV DNA level before (p = 0.076) or after (p = 0.267) HD; however, the mean reduction of HBV DNA by a single HD was 0.11 ± 0.38 Log 10 copies/mL. Patients with low viral load also had a signifi-

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] A revised cutoff value of ALT (17 IU/L) for the uremic patients had been described previously.…”

Section: Definition Of High Alt Levelmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hemodialysis Reduces the Viral Load in Uremic Patients with Chronic Hepatitis B Infection

et al. 2008

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“…Bu hastalar özellikle parenteral yolla bulaşan viral hepatitler açısından risk altındadır. K BY hastalarında sık kan transfüzyonu yapılması, hemodiyalizin vasküler girişim gerektirmesi, erkek cinsiyet, ileri yaş, çok sayıda hastanın aynı ortamda hemodiyalize girmesi, hastalardaki immunsupresyonun enfeksiyonlara duyarlılığı arttırması, geçirilmiş HBV enfeksiyonu, geçirilmiş organ transplantasyonu, sık hastaneye yatış ve cerrahi girişim uygulanması enfeksiyon riskini artıran etmenlerdir (1-6) HD hastaları arasında dünyada bildirilen oranlar; HBsAg pozitifliği için %0-20, Anti-HCV pozitifliği için %4-75 civarındadır (7)(8)(9)(10). Ülkemizde ise HBsAg için %3,1-27,9, Anti-HCV için %2,8-%81,4 pozitiflik bildirilmektedir (11).…”

Section: Introductionunclassified