Prevalence of Occult Hepatitis B Virus Infection in Hemodialysis Patients

Jeong Hwan Yoo; Seong Gyu Hwang; Dong Ho Yang; Kyu Sung Rim; Myung Su Son; Chang-Il Kwon; Kwang Hyun Ko; Sung Pyo Hong; Pil Won Park

doi:10.4166/kjg.2013.61.4.209

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Yoo, Hwang, Yang, Rim, Son, Kwon, Ko, Hong, and Park: Prevalence of Occult Hepatitis B Virus Infection in Hemodialysis Patients

Original Article

Korean J Gastroenterol 2013;61(4):209-214.

Published online: 4 October 2013

DOI: https://doi.org/10.4166/kjg.2013.61.4.209

Prevalence of Occult Hepatitis B Virus Infection in Hemodialysis Patients

Jeong Hwan Yoo, Seong Gyu Hwang, Dong Ho Yang¹, Kyu Sung Rim, Myung Su Son, Chang-Il Kwon, Kwang Hyun Ko, Sung Pyo Hong, Pil Won Park

Department of Internal Medicine, Division of Nephrology, CHA Bundang Medical Center, CHA University, Seongnam, Korea

¹Division of Nephrology, CHA Bundang Medical Center, CHA University, Seongnam, Korea

Correspondence to: Seong Gyu Hwang, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 463-712, Korea. Tel: +82-31-780-5213, Fax: +82-31-780-5246, E-mail: sghwang@cha.ac.kr

Received 10 September 201220 November 2012 Accepted 2 December 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

The prevalence of occult HBV infection depends on the prevalence of HBV infection in the general population. Hemodialysis patients are at increased risk for HBV infection. The aim of this study was to determine the prevalence of occult HBV infection in hemodialysis patients.

Methods

Total of 98 patients undergoing hemodialysis in CHA Bundang Medical Center (Seongnam, Korea) were included. Liver function tests and analysis of HBsAg, anti-HBs, anti-HBc and anti-HCV were performed. HBV DNA testing was conducted by using two specific quantitative methods.

Results

HBsAg was detected in 4 of 98 patients (4.1%), and they were excluded. Among 94 patients with HBsAg negative and anti-HCV negative, one (1.1%) patient with the TaqMan PCR test and 3 (3.2%) patients with the COBAS Amplicor HBV test were positive for HBV DNA. One patient was positive in both methods. Two patients were positive for both anti-HBs and anti-HBc and one patient was negative for both anti-HBs and anti-HBc.

Conclusions

The present study showed the prevalence of occult HBV infection in HBsAg negative and anti-HCV negative patients on hemodialysis at our center was 3.2%. Because there is possibility of HBV transmission in HBsAg negative patients on hemodialysis, more attention should be given to prevent HBV transmission.

Keywords: Hepatitis B virus, DNA, Hepatitis B surface antigens, Hemodilaysis

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Table 1.

Baseline Characteristics of HBsAg Negative Patients

Characteristic	Data
Age (yr)	58 (25–86)
Sex (male： female) Dialysis period (mo)	45：49 38.5 (3–216)
Total bilirubin (mg/dL)	0.28±0.15
AST (IU/L)	18.2±10.4
ALT (IU/L)	16.1±8.7

Values are presented as median (range), n (%), or mean±SD.

Table 2.

Frequency of Various Combinations of Hepatitis B Virus Markers

Anti-HBc	Anti-HBs	Patient
−	−	14 (14.9)
＋	−	12 (12.8)
−	＋	20 (21.2)
＋	＋	48 (51.1)
Total		94 (100.0)

Values are presented as n (%). Anti-HBc, antibody to hepatitis B core antigen; anti-HBs, antibody to hepatitis B surface antigen.

Table 3.

Comparison of Baseline Characteristics between Positive HBV DNA and Negative HBV DNA Group

Characteristic	Total	HBV DNA			p-value ^a
Characteristic	Total	Both method (＋)	Amplicor method (＋)	Both methods (−)	p-value ^a
Patient	94 (100.0)	1 (1.1)	3 (3.2)	91 (96.8)
Age (yr)	58 (25–86)	85	62 (58–85)	58 (25–86)	0.268
Gender (male)	45 (47.9)	1 (100.0)	1 (33.3)	44 (48.4)	0.532
Dialysis period (mo)	38.5 (3–216)	10	82 (10–118)	38 (3–216)	0.471
Total bilirubin (mg/dL)	0.28±0.15	0.25	0.28±0.15	0.26±0.06	0.761
AST (IU/L)	18.2±10.4	9	19.7±3.1	18.1±10.6	0.307
ALT (IU/L)	16.1±8.7	18	15.7±3.2	16.2±8.9	0.699
Anti-HBc	60 (63.8)	1 (100.0)	2 (66.7)	58 (63.7)	0.919
Anti-HBs	68 (72.3)	1 (100.0)	2 (66.7)	66 (72.5)	0.871

Values are presented as n (%), median (range), or mean±SD.

^a This p-value is the result of comparison between HBV DNA positive group and negative group in the COBAS Amplicor HBV monitor test.

Table 4.

Clinical Characteristics of Patients with Positive HBV DNA

Number	Age (yr)	Gender	Anti-HBs	Anti-HBc	HBV DNA
Number	Age (yr)	Gender	Anti-HBs	Anti-HBc	Taqman method (copies/mL)	Amplicor method (copies/mL)
1	85	Male	＋	＋	3,940	11,309
2	62	Female	−	−	ND	1,557
3	58	Female	＋	＋	ND	1,126

Anti-HBs, antibody to hepatitis B surface antigen; anti-HBc, antibody to hepatitis B core antigen; ND, not detected.

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