Occult Hepatitis B Virus Infection in Chronic Hemodialysis Patients in Korea
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-Gu, 135-710, Seoul, South Korea. Hepato-gastroenterology
(Impact Factor: 0.93).
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: The guideline on the management of chronic hepatitis B (CHB) was first developed in 2004 and revised in 2007 by the Korean Association for the Study of the Liver (KASL). Since then there have been many developments, including the introduction of new antiviral agents and the publications of many novel research results from both Korea and other countries. In particular, a large amount of knowledge on antiviral resistance--which is a serious issue in Korea--has accumulated, which has led to new strategies being suggested. This prompted the new guideline discussed herein to be developed based on recent evidence and expert opinion. Target population: The main targets of this guideline comprise patients who are newly diagnosed with CHB and those who are followed or treated for known CHB. This guideline is also intended to provide guidance for the management of patients under the following special circumstances: malignancy, transplantation, dialysis, coinfection with other viruses, pregnancy, and children.
Available from: Ali Reza Samarbasf-Zadeh
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ABSTRACT: Introduction and objective: Hepatitis B virus (HBV) is a member of Hepadnaviridae and a major causative agent of chronic and acute hepatitis, liver cirrhosis and hepatocellular carcinoma. Genotype determination of HBV is based on PCR-RFLP and sequencing of genome of the virus. The genotype formation is mainly due to mutations of HBV precore, S, and YMDD (tyrosine-methionine-aspartate-aspartate motif in the C domain of the HBV DNA polymerase gene) genome area. Moreover, some of the mutant HBV remains undetectable by serological tests (occult hepatitis). Since the genotypes of HBV and occult hepatitis B has not been studied in our area, this study was conducted to determine both occult hepatitis B infection and genotypes among hemodialysis patients.Materials and methods: Two hundred and fifty hemodialysis patients were selected in this study. The sera of the patients were collected and the extracted DNA was used as template of PCR to amplify a 479bp fragment of the viral genome. The PCR products were digested by Ava2 and Mbo1 restriction enzymes. Based on RFLP patterns, the genotypes were determined. The HBV markers including; HBV surface antigen (HBsAg), hepatitis Bc antibody (HBcIgG), hepatitis B virus e antigen (HBeAg) and hepatitis B virus e antibody (HBeAb) were carried out for all the patients by ELISA test.Results: Fifty (20%) out of 250 sera showed positive HBV by PCR. Out of the 50 positive cases for HBV, 46(92%) belonged to genotype D2 and 2(4%) cases of them were B6 genotype. Ten cases were positive for HBV by PCR test but negative by ELISA test (4% occult hepatitis). Conclusion: Prevalence of HBV infection was high among the dialysis patients (20%), and occult hepatitis B was 4% in these patients. The dominant genotype of HBV was D2 (92%) followed by genotypes B6 (4%) in hemodialysis patients.
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