The authors declare that they have no competing interests.
TH, JC and AD proposed the project. TH designed and led the project. LS collected clinical and laboratory data. TH and LS analysed the data. WL and MP carried out laboratory tests. AO’R advised on the project. Statistical analysis was by TH and LS. LS wrote the first draft and all authors read and approved final draft.
Haemodialysis patients are at increased risk of exposure to blood borne viruses. To reduce transmission in the UK, all haemodialysis patients are regularly screened, and if susceptible to Hepatitis B virus (HBV) infection, vaccinated.
This retrospective study was undertaken to determine the HBV immune status in a large dialysis cohort and the prevalence of occult HBV infection, defined as the presence of anti-HBcore antibody (anti-HBcAb) and HBV DNA without detectable HB surface antigen (HBsAg). Information on HBV status was retrieved from haemodialysis patients under the care of The Royal Free Hospital, London, UK between 2009–2010. Available sera from 138 of 161 anti-HBcAb positive/HBsAg negative individuals were anonymised and tested for HBV DNA by a real time quantitative PCR.
15 (2%) of 793 patients had chronic HBV infection (HBsAg positive). 161 (20%) were anti-HBcAb positive but HBsAg negative suggesting past infection. 335 (54%) of the remaining 617 patients were considered immune following vaccination (anti-HBsAb > 10 IU/L). Three (2.2%) of the 138 anti-HBcAb positive, HBsAg negative patients had detectable HBV DNA (3, 5 and 9 IU/ml). Standard liver function tests were normal in these patients.
In a large multi-ethnic London haemodialysis cohort, 20% patients had evidence of past HBV infection. Despite this, the prevalence of occult HBV was found to be low and the very low levels of HBV DNA detected are unlikely to pose a nosocomial transmission risk in the presence of robust vaccination and infection control measures.
Kozeil MJ, Thio CL. Hepatitis B virus and hepatitis delta virus. In: Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, vol. 2. 7th ed. 2010. p. 2059–95. CrossRef
Good Practice Guidelines for Renal Dialysis/Transplantation Units: Prevention 2and Control of Blood-borne Virus Infection. Department of Health; 2002. http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4005752.
Guidelines for dialysis away from base. Addendum. Good Practice Guidelines for Renal Dialysis/Transplantation Units: Prevention and Control of Blood-borne Virus Infection. Department of Health; 2010. https://www.gov.uk/government/publications/prevention-and-control-of-blood-borne-virus-infection-addendum-guidelines-for-dialysis-away-from-base.
Ahmadi F, Ramezani M, Razeghi E, Ranjbarnovin N, Khazaeipour Z. A randomized controlled trial of two schedueles of hepatitis B vaccination in predialysed chronic renal failure patients. Hepat Mon. 2011;12(5):344–8. CrossRef
Immunisation against Infectious disease. Hepatitis B virus. Chapter 18. Department of Health; 2006. http://www.gov.uk/government/uploads/system/uploads/attachment_data/file/263311/Green_Book_Chapter_18_v2_0.pdf accessed 3rd Feb 2015.
Garson JA, Grant PR, Ayliffe U, Ferns RB, Tedder RS. Real-time PCR quantitation of hepatitis B virus DNA using automated sample preparation and murine cytomegalovirus internal control. J Virol Methods. 2005;126(1–2):201–13.
Jardim RN, Gonçales NS, Pereira JS, Fais VC, Gonçales Junior FL. Occult hepatitis B virus infection in immunocompromised patients. Braz J Infec Dis. 2008;12:300–5.
Hepatitis B infected healthcare workers and antiviral therapy. Department of Health; 2007. http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_073164 accessed 3rd Feb 2015.
- The prevalence of occult hepatitis B virus (hbv) infection in a large multi-ethnic haemodialysis cohort
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II