Occult hepatitis B in renal transplant patients.
BACKGROUND
Occult hepatitis B (HB) is characterized by the presence of HBV-DNA in patients who do not have HB surface antigen (HBsAg) detectable in sera, and is frequently described in patients with hepatitis C virus (HCV) infection. These viral liver diseases are common and may have a negative impact on the survival of renal transplant patients, especially if they are both present. In this study we aimed to evaluate the prevalence of occult HB in renal transplant patients either with or without HCV infection.


METHODS
In a cross-sectional survey 101 HbsAg-negative renal transplant patients were evaluated; 51 were anti-HCV positive. Sera were analyzed for the presence of the S and core genes of the HBV-DNA by a nested polymerase chain reaction technique. Markers of HBV infection and liver function tests were also analyzed.


RESULTS
The core gene was identified in 1 HCV-infected patient and 1 anti-HCV-negative patient who also presented the S gene (prevalence: 2% and 1% for each gene, respectively). HCV-infected patients had longer pre-transplant dialysis time (50.8 +/- 34.6 vs. 32.0 +/- 20.9; P < 0.001). Liver function tests were also increased in the HCV-infected group: alanine aminotransferase (P < 0.001), aspartate aminotransferase (P < 0.05), gamma-glutamyl transpeptidase (P<0.02), and alkaline phosphatase (P < 0.04). Multivariate analysis revealed that HCV infection was the only determinant of the altered results of the liver function tests.


CONCLUSIONS
We found that occult HB is a condition present in our population of renal transplant patients and that HCV infection does not seem to be associated with occult HB infection in this setting.
Peres
A A
AA
Post Graduate Medical Sciences: Nephrology Program, School of Medicine, Federal University of Rio Grande do Sul, Divisions of Nephrology and Hepatology, Hospital de Clínicas de Porto Alegre, Brazil.
Dias
E A
EA
Chesky
M
M
Alvares-da-Silva
M R
MR
Jobim
L F
LF
Gonçalves
L F
LF
Manfro
R C
RC
D000328:Adult; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D016174:Hepacivirus; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006515:Hepatitis B virus; D006526:Hepatitis C / Q000150:complications / Q000821:virology; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015995:Prevalence
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies