Prevalence of Occult HBV Infection in Dialysis Patients Referred to Sari Dialysis Center

Background and

One of the possible factors for the continuation of hepatitis B infection in hemodialysis adults is the presence of hidden hepatitis B. Considering the risk of occult hepatitis B infection in people with immunodeficiency disorders, especially hemodialysis patients, the aim of this study was to investigate the frequency of occult hepatitis B among dialysis patients in Sari.

This cross-sectional descriptive research was conducted in Sari, 2018. Blood samples were taken from dialysis patients before dialysis. Then, HBV serology tests (HBs-Ab, HBs-Ag, HBV PCR, and HBc-Ab) were performed using ELISA method. Data analysis was done using SPSS V20. Chi-square test was used to find correlation between qualitative variables. Also, the differences were compared using independent t-test, and P<0.05 was considered significant.

A total of 279 dialysis patients were investigated in this study. The chi-square test showed that there was no significant difference between the two groups in terms of gender (P>0.05), but significantly, the majority of the studied patients had a previous history of diabetes and high blood pressure (P<0.05). The findings revealed that there was no significant relationship between latent hepatitis B and demographic information (P>0.05). Independent t-test showed that the average age of people with latent hepatitis B was significantly higher than the rest of dialysis patients. (P=0.030). Of the patients, nine (3.23%) had positive HBs-Ag, of whom seven were under treatment and two did not need any treatment. Despite two complete series of vaccination against hepatitis B, six patients (2%) with negative HBs-Ag and HBs-Ab were reported to have positive HBc-Ab. Two cases of them (0.71%) were PCR positive, which were real latent hepatitis, and four others were recorded as old recovered hepatitis.

The findings suggested that HBs-Ag was a necessary but not sufficient factor in patients with End-Stage Renal Disease (ESRD); therefore, it was recommended to evaluate HBc-Ab and to test PCR for positive cases.