Hepatitis B Virus DNA in Serum of Hepatitis B Surface Antigen Negative Hemodialysis Patients

Abstract

Hepatitis B virus (HBV) infection remains a serious issue in the dialysis population. Transmission of HBV through dialysis machines or other sources as well as seroconversion from HBV negative patients to positive ones is still not well understood. Seventy patients were selected from our chronic hemodialysis (HD) center. They were divided into two groups: Group (I) included 35 patients with negative hepatitis B surface antigen (HBsAg), while another 35 already known to have HBsAg positive were chosen as a control group (Group II). The aim of the study was to detect the presence of HBV DNA by analyzing the serum PCR of the negative (HBsAg) patients (Group I) then analyzing the viral sequencing of 5 of them in compari-son to 5 of the known HBsAg positive. All patients received blood transfusions, were positive for HCV but negative for HDV and HIV. In group I, HBV DNA by PCR was detected in serum of 17/35 (48.5%) patients. Only 3 of them were positive for HBcAb. In group II, HBV DNA by PCR was detected in serum of 35/35 (100%) patients. The alanine transaminase enzyme (ALT) level was significantly higher than negative patients. Sequencing of the virus showed some mutated segments in 5 of the positive DNA by PCR compared to already positive HBsAg positive patients in Group II. In conclusion, a high proportion of HBsAg-negative hemodialysis patients were found to have positive HBV DNA by PCR. Sequencing of the virus revealed some mutated segments of the DNA. These findings are of major importance for the planning of future screening of patients on hemodialysis. We recom-mend measuring HBV DNA of all negative HBsAg patients on HD as this can change the management and prognosis of this particular group on chronic HD.