Prevalence of Occult Hepatitis B Virus Infection in Hemodialysis Patients From Egypt With or Without Hepatitis C Virus Infection

Abstract

Background: While prevalence of Hepatitis B virus (HBV) in patients with end-stage renal failure (ESRF) who are undergoing dialysis has decreased significantly during the past few decades, it still remains a distinct clinical problem. The immunosuppressive nature of renal disease often leads to chronicity of the HBV infection and an opportunity for nosocomial spread of the infection among dialysis patients. Egypt is among the countries with intermediate endemicity of HBsAg (range, 2%-7%). Large-scale geographic heterogeneity in HBV prevalence has been reported worldwide and HBV prevalence is especially heterogeneous in Egypt. Objectives: To assess the prevalence of occult HBV infection (OBI) in hemodialysis patients with or without chronic hepatitis C (HCV) from Minia and Assuit, Upper Egypt, using HBV DNA assays. Patient and Methods: Sera from 145 hemodialysis patients with negative HbsAg were investigated for HBV DNA using real-time polymerase chain reaction (RT-PCR). Only serum samples with repeatedly detectable HBV DNA were considered positive. Patients were divided into 2 groups: HCV RNA positive and HCV RNA negative, based on the results of a third generation enzyme linked immunosorbent assay (ELISA) anti-HCV test and HCV RNA PCR. Results: HBV DNA was detected in 6 of the 145 patients (4.1%) and HBcAb was detected in 29/145 patients (20%). There were no statistically significant differences in the age, duration of hemodialysis, biochemical parameters, serological markers of HBV, or HBV DNA between patients with and without HCV infection. Conclusions: Four percent of the hemodialysis patients had OBI. There was no significant difference in the prevalence of OBI between hemodialysis patients with or without HCV co-infection.

Prevalence and Risk Factors of Hepatitis B and Hepatitis C Virus Infections among Patients with Chronic Renal Failure in Zabeed City, Yemen Republic

“…The present study results show significant differences in regard to sex had higher in male than female between hemodialysis patients with HBV or HCV infection. In accord [12] [14] studies results which did not show significant differences in regard to age between hemodialysis patients with HBV or HCV infection compared with hemodialysis patients without HBV or HCV infection whereas, this does not comply with [21] study that reported a statistically significant relationship between HBV infection and age of the patients in a way that patients aged less than 40 years were found to be more susceptible to HBV than older patients. This observation is in agreement with a previous report from Libya showing that the highest prevalence of HCV antibodies was observed in HD patients aged 36 -55 years [17].…”

“…Overall, the prevalence and incidence of HBV and HCV infections in HD patients reflects the prevalence of these infections in the general population, the quality of healthcare services in a community and the standards of infection control practices in HD units are related. The results of [20] study, showed that male hemodialysis patients had higher HBV prevalence, whereas [14] study showed that male hemodialysis patients had higher HCV prevalence. These results are in disagreement with the results of study [12].…”

“…The HBV prevalence rate varies from one dialysis unit to another. The prevalence rate in Europe is reported to be 23% -43%, in USA 16% -18%, in Tunisia 18%, in France 2.2%, in Russia 39% -50%, and in South Africa 17% [14]. Generally, more than half of the infected patients on dialysis become persistent, symptoms hepatitis B surface antigen (HBsAg) carriers without biochemical evidence of hepatitis [13].…”

High Incidence of Hepatitis B Virus Infection in Hemodialysis Patients at Sanglah General Hospital and It’s Risk Factors

“…In one recent study of haemodialysis patients in Egypt who were negative for HBsAg, hepatitis B DNA was detected in 4.1% and HBcAb in 20%. 37 It is therefore possible that we failed to detect cases of occult hepatitis B infection.…”

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

“…The prevalence of OBI in HD patients varies markedly from one locality to another worldwide, with a range of 0% to 36 % (13) . In Egypt, the prevalence was reported at 4% in Minia and Assuit (Upper Egypt) and reached 26.8% among patients in Alexandria (North Egypt) (23) (24) . Even with these recent data addressing the prevalence of OBI in patients on HD in Egypt, more comprehensive data may be needed to evaluate OBI among chronic HCV carriers and to determine whether the prevalence differs following HD, as both HCV carriers and chronic HD patients may serve as a potential source for the spread of OBI in the community.…”