Occult HBV infection status among chronic hepatitis C and hemodialysis patients in Northeastern Egypt: regional and national overview

Abstract

Introduction:Occult hepatitis B infection (OBI) is considered to be one of the major risks for patients suffering from end-stage renal disease (ESRD) on regular hemodialysis (HD) and patients with chronic hepatitis C virus (HCV) infection. This study compared the prevalence of OBI among these two high-risk groups in the Suez Canal region, Northeastern Egypt, to obtain a better national overview of the magnitude of OBI in this region. Methods: Serum samples were collected from 165 HD patients and 210 chronic HCV-infected patients. Anti-HCV antibody, hepatitis B surface antigen (HBsAg), total hepatitis B core (anti-HBc) antibody, and hepatitis B surface antibody (anti-HBs) were detected by enzyme-linked immunosorbent assay (ELISA). HCV RNA was detected using a quantitative real-time RT-PCR assay, and HBV was detected using a nested PCR. Results: All patients were negative for HBsAg. A total of 49.1% and 25.2% of the patients in the HD and HCV groups, respectively, were anti-HBc-positive. In addition, more anti-HBs-positive patients were detected in the HD group compared to the HCV group (52.1% and 11.4%, respectively). Three cases were positive for HBV DNA in the HD group, while eighteen positive cases were detected in the HCV group. Both study groups showed signifi cant differences in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level as well as anti-HBc, anti-HBs and HBV-DNA positivity. Conclusions: OBI was more prevalent among chronic HCV patients than HD patients in the Suez Canal region, Egypt, with rates of 8.5% and 1.8%, respectively. However, more precise assessment of this infection requires regular patient follow-up using HBV DNA detection methods.

Low prevalence of occult hepatitis B virus infection in chronic haemodialysis and kidney transplant patients

“…Several reports have shown a significant association between OBI and HCV infection . As both HBV and HCV share the same transmission mode, a higher prevalence of co‐infections seems plausible especially in endemic areas or in persons with parental risk factors such as haemodialysis.…”

“…Several reports have shown a significant association between OBI and HCV infection. [36][37][38] As both HBV and HCV share the same transmission mode, a higher prevalence of co-infections seems plausible especially in endemic areas or in persons with parental risk factors such as haemodialysis. In our study, not unexpectedly, the anti-HCV prevalence was higher in the CHD cohort (3.7%) and KTx cohort (4.8%) than in the general German population.…”

Update on occult hepatitis B virus infection

“…In addition, HCV “core”, NS2 and NS5A proteins could strongly inhibit HBV replication[ 34 , 43 , 49 - 51 ]. Table 1 shows the distribution of OBI among patients with HCV infection[ 52 - 66 ].…”

Hepatitis B variants among Egyptian patients undergoing hemodialysis

“…have previously stated that detection of anti‐HBc alone (isolated anti‐HBc) may reflect unrecognized OBI in patients undergoing HD . Furthermore, previous studies have shown that patients who are positive for total anti‐HBc and/or anti‐HBs may have OBI . To the best of our knowledge, this is the first study to determine the prevalence of precore mutation (2/28; 7.1%) among patients undergoing HD in Egypt.…”