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Occult Hepatitis B Virus Infection in Hemodialysis Patients in Japan
Authors:Tomokatsu Saijo  Nobuhiko Joki  Yoji Inishi  Mikako Muto  Motohiko Saijo  Hiroki Hase
Affiliation:1. Saijo Clinic Takaban, Tokyo, Japan;2. Division of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan;3. Sawai Clinic, Tokyo, Japan;4. Saijo Clinic Shimouma, Tokyo, Japan
Abstract:Hepatitis B surface antigen is widely used in hepatitis B virus surveillance; patients who test negative for the antigen are judged to be uninfected. However, occult hepatitis B virus infection has been confirmed with hepatitis B virus DNA at low levels in the liver and peripheral blood in patients positive for hepatitis B core antibody or hepatitis B surface antibody, even if they test negative for hepatitis B surface antigen. To investigate the prevalence of occult hepatitis B virus in hemodialysis patients, we performed cross‐sectional analysis of 161 hemodialysis patients in two related institutions for hepatitis B surface antigen, hepatitis B core antibody, and hepatitis B surface antibody. Hepatitis B surface antigen, hepatitis B core antibody, or hepatitis B surface antibody was present in 45 patients (28.0%). Hepatitis B virus DNA was present in six patients (3.7%), all of whom also tested positive for hepatitis B core antibody. Hepatitis B surface antibody positivity was unrelated in only one of the six patients. Four of the six patients were positive for hepatitis B surface antigen; however, two (1.3%) of these with occult hepatitis B virus infection were found to be hepatitis B surface antigen negative. Occult hepatitis B virus infection may be missed in hepatitis B virus surveillance using hepatitis B surface antigen alone; therefore, routine hepatitis B core antibody screening is necessary. Patients who test positive for hepatitis B core antibody should undergo further hepatitis B virus DNA testing to enable accurate hepatitis B virus screening.
Keywords:Hemodialysis  Hepatitis B core antibody  Hepatitis B virus  Occult hepatitis B virus infection  Surveillance
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