Occult hepatitis B virus infection in hemodialysis patients

Abstract

Introduction: occult hepatitis B virus infection is characterized by the presence of the viral genome and antibodies to the capside protein in serum or plasma (antiHBc) that test negative for the infection marker. Objectives: to detect the occult hepatitis B virus in hemodialysis patients and to identify the possible relationship between occult hepatitis B infection and hepatitis C virus infection and the epidemiological and demographic variables. Methods: seventy thousand and nine serum samples from patients treated in 18 hemodialysis units were included. Serological markers for HBV infection, exposure and immunity were tested. Samples with negative HBsAg, positive anti-HBc and anti-HBs titers <50 IU/L were tested for detection of HBV-DNA and HCV markers. Results: the prevalence of HBV infection and exposure were 6.9% and 28.6% respectively. In the group, 4.3% of samples met occult hepatitis B infection criteria, the HBV-DNA was detected in 58.1% (18/31) of the samples, with viral loads below 105 IU/mL. Overall occult hepatitis B infection prevalence was 2.5% (18/709). There was no significant association among the analyzed variables. Conclusions: occult hepatitis B infection was frequent in hemodialysis patients with low levels of anti-HBs mainly in those with non protected titers. This study supports the need of keeping the prevention strategies against parenterally transmitted viral hepatitis in dialysis units.