فراواني عفونت نهفته ويروس هپاتيت B در بيماران همودياليزي

Occult Hepatitis B Virus Infection in Hemodialysis Patients

Background and objective: Occult hepatitis B virus (HBV) infection is characterized by presence of HBV infection with undetectable hepatitis B surface antigen (HBsAg). Occult HBV infection harbors potential risk of HBV transmission through haemodialysis. Sometimes the isolated anti-HBc pattern (without HBsAg and anti-HBs) is the only marker for chronic HBV infection. The aim of this study was to assess the occult HBV infection in hemodialysis patients. Materials and methods: A total of 289 HD patients from five dialysis units in Tehran were included in this study. HBsAg, anti-HBs, anti-HBc, anti-HCV, ALT and AST levels were tested in all subjects. The presence of HBV-DNA was determined in plasma samples of patients with isolated anti-HBc by real-time PCR. Results: Of 289 patients enrolled in this study, 18 subjects (6.2%, 95% CI, 3.5%-8.9%) had isolated anti-HBc. HBV-DNA was detectable in 9 of 18 patients (50%, 95% CI, 27%-73%) with isolated anti-HBc. Plasma HBV-DNA load was less than 50 IU/ml in all of these patients. Conclusion: Isolated anti-HBc could reflect unrecognized occult HBV infection in hemodialysis patients. Screening of these patients is useful to preventing of HBV transmission.