Occult hepatitis B virus infection among chronic hemodialysis patients in Alexandria, Egypt

Abstract

The prevalence of end-stage renal disease has increased dramatically in developing countries. Hepatitis B virus (HBV) infection is a global health problem that represents a significant co-morbidity event that has led to outbreaks of hepatitis B. There are inadequate data concerning occult HBV infection among Egyptian chronic hemodialysis patients. This study aimed to detect occult HBV infection among chronic hemodialysis patients in Alexandria, Egypt. A cross-sectional study was performed on 100 patients with end-stage renal disease that received maintenance hemodialysis and had tested negative for HBV surface antigen. Blood samples were collected before the initiation of hemodialysis. Sera were tested for hepatitis C virus (HCV) and hepatitis B core (HBc) antibodies using ELISA, and HBV DNA was detected by SYBR Green real-time PCR using specific primers for the s and c genes and by nested PCR using pol gene-specific primers. The serum activity of alanine and aspartate aminotransferase (ALT and AST) were also measured. Anti-HCV and anti-HBc antibodies were detected in 34% and 48% of patients, respectively, and 70.6% of anti-HCV positive patients were also positive for anti-HBc antibodies. This association was statistically significant (p=0.001). HBV DNA was detected in 32% of the hemodialysis patients. A significant association was determined between the presence of HBV DNA and anti-HCV positivity (p=0.021). Aminotransferases were elevated in 21% of the studied patients, more often in patients with positive anti-HCV profiles than in patients negative for anti-HCV (p<0.05). In conclusion, the serological markers of HBV infection should be verified with molecular tests to investigate possible occult infections, especially among anti-HBc-positive hemodialysis patients, to improve our understanding of their clinical, laboratory, and epidemiological characteristics.

Absence of Occult Hepatitis B Virus Infection in Haemodialysis Patients in White Nile State, Sudan

“…However the study findings disagreed with the results obtained by Abdalhafeez AM et al in Sudan where 3 haemodialysis patients (3.3%) were positive for occult HBV infection In contrast; very high (32%) incidence of OBI was reported by Helaly et al in Alexandria, Egypt in chronic haemodialysis patients [8,9]. On the moderate side; Tomokatsu et al in Japan reported that 6 haemodialysis patients (3.7%) were found to harbor occult HBV, and Andrea et al in northeast Brazil reported that 7 patients (2.3%) were HBV-DNA positive [10,11].…”

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.…”

Seropositive Form of Occult Hepatitis B Virus Infection in Iranian Patients with Cryptogenic Liver Cirrhosis

“…of the host immune response, and the interference of the other viruses in HBV pathogenesis have been proposed as the possible reason of occult infections (17)(18)(19).…”