title: Biological dynamics of hepatitis B virus load in dialysis population.
abstract: BACKGROUND
  Control of the spread of hepatitis B virus (HBV) infection in dialysis units has been one of major advances in the management of end-stage renal disease. However, the natural history of HBV in dialysis patients remains unclear. The aim of this study is to measure monthly HBV viral load (HBV DNA) in a large cohort (n = 29) of hepatitis B surface antigen (HBsAg)-positive chronic dialysis patients during 12 months.
  
  
  METHODS
  HBV DNA was measured using the Amplicor HBV Monitor Test (Roche Diagnostics, Branchburg, NJ), an in vitro assay using polymerase chain reaction nucleic acid amplification and DNA hybridization for the quantitative measurement of HBV DNA in serum.
  
  
  RESULTS
  We observed three HBV DNA patterns: (1) patients persistently positive by Amplicor HBV Monitor Test (persistent HBV DNA; 7 of 29 patients; 24.1%), (2) individuals with alternatively positive and negative results (intermittent HBV DNA; 18 of 29 patients; 62.1%), and (3) patients persistently negative by Amplicor HBV Monitor Test (4 of 29 patients; 13.8%). HBV viral load was greater in patients with persistent compared with intermittent HBV DNA (persistently HBV DNA positive; 2.686 x 10(4) copies/mL; 95% confidence interval [CI], 5.2499 x 10(4) to 1.8158 x 10(4)copies/mL) versus intermittently HBV DNA positive (1.071 x 10(3) copies/mL; 95% CI, 8.524 x 10(3) to 4.09 x 10(2) copies/mL; P = 0.0001). In the entire group, HBV load at study entry was low and did not change versus the end of follow-up.
  
  
  CONCLUSIONS
  Three patterns of HBV viremia in dialysis patients over time were assessed; HBV load was not high and was relatively stable. HBsAg-positive patients who were intermittently HBV DNA positive had less HBV viral load than persistently HBV DNA-positive patients. Periodic testing for HBV DNA to assess the virological status of HBsAg-positive dialysis patients is recommended.
authors.affiliation: Nephrology and Dialysis Division, Institute of Hygiene and Preventive Medicine, Maggiore Hospital, IRCCS, Milano, Italy. fabrizi@policlinico.mi.it
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fabrizi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Lunghi
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Alongi
authors.forename: Sergio
authors.initials: S
authors.lastname: Bisegna
authors.forename: Gesualdo
authors.initials: G
authors.lastname: Campolo
authors.forename: Stefano
authors.initials: S
authors.lastname: Mangano
authors.forename: Aurelio
authors.initials: A
authors.lastname: Limido
authors.forename: Bruno
authors.initials: B
authors.lastname: Pagliari
authors.forename: Fabio
authors.initials: F
authors.lastname: Tettamanzi
authors.forename: Claudio
authors.initials: C
authors.lastname: Ponticelli
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006514:Hepatitis B Surface Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000150:complications / Q000821:virology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D019562:Viral Load; D014766:Viremia / Q000150:complications / Q000821:virology*
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase