Occult hepatitis B virus infection in chronic hemodialysis patients in Korea.
ABSTRACT Occult HBV infection that is serum HBsAg negative but HBV DNA positive is thought to be a contributing factor to ongoing HBV transmission within hemodialysis units. In the present study, the prevalence of occult HBV infection was investigated in patients on chronic hemodialysis in Korea, an endemic region for HBV.
Eighty-three patients undergoing maintenance hemodialysis at Samsung Medical Center, Seoul, South Korea were included. Serum samples were obtained from all patients. Testing for HBsAg, anti-HBs and anti-HBc was performed by an electrochemiluminescence immunoassay. HBV DNA was detected by the nested PCR method.
Among the 83 patients, 4 (4.8%) were HBsAg positive and HBV DNA positive. The remaining 79 patients were confirmed HBsAg-negative/HBV DNA-negative. Thus, the prevalence of occult HBV infection was 0%. All of the HBsAg-positive patients were anti-HBs-negative/anti-HBc-positive. Of 79 HBsAg-negative patients, 58 (73.4%) were anti-HBs positive and 52 (65.8%) were anti-HBc positive.
The present study showed that the prevalence of occult HBV infection in chronic hemodialysis patients at our center in Korea was not increased compared to the rates of low endemic regions. Furthermore, occult HBV infection was not a contributing factor in HBV transmission in the hemodialysis unit studied.
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ABSTRACT: Hemodialysis patients are at an increased risk of acquiring hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. However, the prevalence of hepatitis viral infection and its genotype distribution among hemodialysis patients in Indonesia are unclear. In order to investigate these issues and the possibility of nosocomial transmission, 161 hemodialysis patients and 35 staff members at one of the hemodialysis unit in Yogyakarta, Indonesia, were tested for serological and virological markers of both viruses. HBV surface antigen (HBsAg) was detected in 18 patients (11.2%) and in two staff members (5.7%). Anti-HCV was detected in 130 patients (80.7%) but not in any staff members. Occult HBV and HCV infection were detected in 21 (14.7%) and 4 (12.9%) patients, respectively. The overall prevalence rates of HBV and HCV infection among patients were 24.2% and 83.2%, respectively. HCV infection was independently associated with hemodialysis duration and the number of blood transfusions. Phylogenetic analysis revealed that 23 of 39 tested HBV strains (59%) were genotype B, 11 (28.2%) were genotype C, and 5 (12.8%) were genotype A. HCV genotype 1a was dominant (95%) among 100 tested HCV strains. Nosocomial transmission was suspected because the genotype distribution differed from that of the general population in Indonesia, and because the viral genomes of several strains were identical. These findings suggest that HBV and HCV infection is common among hemodialysis patients in Yogyakarta, and probably occurs through nosocomial infection. Implementation of strict infection-control programs is necessary in hemodialysis units in Indonesia.Journal of Medical Virology 08/2013; 85(8):1348-61. DOI:10.1002/jmv.23581
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ABSTRACT: We investigated the prevalence of occult hepatitis B virus (HBV) infection in Japanese chronic hemodialysis patients. Hemodialysis patients (n = 1041) were screened for occult HBV. The presence of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody, and hepatitis B core antibody (anti-HBc) was determined by various chemiluminescent immunoassays. HBV-DNA was quantified in patients positive for anti-HBc using quantitative real-time polymerase chain reaction. Among the 1041 patients, six (0.6%) were HBsAg-positive and 218 (20.9%) were anti-HBc-positive. All HBsAg-positive patients also tested positive for the presence of HBV DNA. Of 212 HBsAg-negative and anti-HBc-positive patients, three were positive for HBV DNA. Our study showed that the prevalence of occult HBV infection in chronic hemodialysis patients from eastern Japan was 0.3%.Therapeutic apheresis and dialysis: official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy 06/2013; 17(3):289-92. DOI:10.1111/1744-9987.12006
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ABSTRACT: Hemodialysis patients potentially have an increased risk of infection with parenterally transmitted viral agents due to an impaired host immune response and multiple transfusion requirements. Viral hepatitis is considered as a problem for hemodialysis patients because 1.9% of all deaths among this population are related to the consequence of viral hepatitis. Hepatitis B virus (HBV) is one of the most important causes of transmitted infections by the parenteral route in hemodialysis patients. Occult HBV infection is characterized by presence of HBV infection without detectable hepatitis B surface antigen (HBsAg), which harbors potential risk of HBV transmission through hemodialysis. There are conflicting reports on the prevalence of occult HBV infection (OBI) in hemodialysis patients. Considering the importance of occult HBV infection in hemodialysis patients and the growing evidence on this subject, the purpose of this review is to provide comprehensive information on OBI prevalence in hemodialysis patients and highlight the most important points in this issue.Therapeutic apheresis and dialysis: official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy 08/2012; 16(4):328-33. DOI:10.1111/j.1744-9987.2012.01072.x