Occult hepatitis B virus infection among hemodialysis patients

Abstract

Hepatitis B virus is a major public health impasse all over the world. Recently a new form of hepatitis B infection named Occult hepatitis B Infection (OBI) has appeared globally. The OBI is defined as the presence of HBV DNA in the liver and/or blood in the absence of detectable serum HBsAg with/without anti-HBc or anti-HBs. The prevalence of OBI has been reported in hemodialysis (HD) patients in different regions of the world. Thus, this study investigated the prevalence of OBI among HD patients. The cross-sectional study was carried out on 84 HD patients. These sera were checked for HBsAg, HBc-IgG assessment using Enzyme linked immunosorbent assay. The DNA was extracted from the sera samples and tested for HBVDNA detection using Nested Polymerase Chain Reaction (Nested PCR). The liver function tests including serum alanine aminotransferase and aspartate aminotransferase levels were carried out for all the HD individuals. 52/84(61.9%) of HD were males and 32/84 (38.1%) were females. The patient’s age ranged from 25 to 64 with a mean age of 52.4±15.2 years. HBsAg and HBc-IgG were detected in 1(1.1%) female. 2 (2.4%; a female and a male) patients were positive for HBsAg. 14/84 (16.7%; 6 female and 8 male) HD patients were positive for anti-HBc but negative for HBsAg, among them 4(28.6%; 2 female and 2 male) cases were positive for HBV DNA, indicating the presence of OBI in HD patients. Even distribution of OBI among the HD was found in 2(2.36%) male and 2(2.36%) female (P>.0.05). In the present study the moderate rate of 4.76% OBI has been observed in HD patients. The prevalence of seropositive OBI among the gender was 2(2.36%) male and 2(2.36%) female. The seronegative OBI have not been detected in the present study but requires further investigation. In this study the affliction of OBI in HD patients is not clear.

High Prevalence of Occult Hepatitis B Virus Infection among Iranian Hemodialysis Patients

“…This screening policy in combination with dialysis-specific preventive measures, including isolation decisions, training the medical staff and active vaccination, can minimize the risk of HBV transmission in dialysis centers. 4 The prevalence of 10.4% for occult HBV infection reported in this study is higher than those observed among hemodialysis patients in the other parts of Iran, 0.0% in Guilan (northern Iran), 19 0.0% in Isfahan (central Iran), 18 0.8% in Yazd (central Iran), 17 0.5% in Tehran (north-central Iran), 20 4.7% in Ahvaz (southwestern Iran), 21 and 6% in Zanjan (western Iran). 22 The prevalence of occult HBV infection detected in this study is also higher than those reported among hemodialysis patients of some other regions and countries, 0.0% in Al-Nasiriyah, Iraq 23 ; 0.3% in eastern Japan 24 ; 0.9% in central Greece 25 ; 1.3% in South Korea 26 ; 2.2% in London, United Kingdom 27 ; and 2.3% in northeastern Brazil 28 but lower than those reported among hemodialysis patients in Egypt (32%) 29 and Sudan (15.9%).…”

“…2 In addition, those studies using real-time PCR assay 17,18,20 to detect HBV DNA have reported a lower prevalence rate than the studies using nested PCR assay. 21,22,32 However, the probability of contamination with PCR product during procedures that can result in false-positive results considers as the main limitation of the nested-PCR method. 31 In the present study, strict quality controls and positive and negative controls were applied to avoid contamination and to ensure the accuracy of the results.…”