Screening of HBV in Patients of Hemodialysis using HBs Ag in combination with HBcAb (IgG)

Abstract

Hepatitis B virus (HBV) infection can lead to acute or chronic hepatitis, cirrhosis, or hepatocellular carcinoma. HBV infection in dialysis patients presents a distinct clinical problem in view of the immunosuppressive effect of renal failure, the susceptibility for de novo infection and nosocomial transmission, the long-term implications on morbidity and mortality, and the change in clinical course after kidney transplantation. The natural history of HBV infection in dialysis patients may also vary according to the timing of infection and genotype. Chronic hemodialysis patients are at high risk for infection because the process of hemodialysis requires vascular access for prolonged periods. In an environment where multiple patients receive dialysis concurrently, repeated opportunities exist for person-to-person transmission of infectious agents, directly or indirectly via contaminated devices, equipment, environmental surfaces or hands of personnel. Prevention of HBV infection through universal precautions and vaccination are of critical importance.Hepatitis B virus (HBV) infection is a global health problem that represents a significant co-morbidity event that has led to outbreaks of hepatitis B. The estimated residual risk of HBV transfusion transmission remains significantly higher thanthe risk of either HIV-1 or HCV.There are inadequate data concerning occult HBV infection among Egyptian chronic hemodialysis patients. This study aimed to detect prevalence of HBV infection &OBI among chronic hemodialysis patients in Cairo. The manifestations of acute HBV infection in dialysis patients are variable. The manifestations of chronic hepatitis B or HBV-induced cirrhosis in dialysis patients are identical to those without renal failure. Amino-transferase levels indicate hepatitic activity, but need to be interpreted according to the adjusted normal range, which is lower in patients on long-term dialysis. Hepatitis B infection leads to liver complications and reduces the survival of kidney transplant recipients. OBI is simply defined as serologically undetectable hepatitis B surface antigen (HBsAg-ve), despite the presence of circulating HBV DNA. In some persons, the only HBV serologic marker detected is anti-HBc (i.e., isolated anti-HBc), so anti-HBc test should be used, as a less than ideal surrogate marker if highly sensitive HBV-DNA testing is not feasible.