Prevalence of occult hepatitis B and hepatitis C virus infections in Turkish hemodialysis patients.
OBJECTIVE
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are important causes of morbidity and mortality in maintenance hemodialysis patients. Although their exact prevalence is not known, HBV and HCV viral infections and occult viral hepatitis are frequent in these patients. This study aimed to determine the prevalence of occult HBV and HCV infections in maintenance hemodialysis patients.


METHODS
One hundred and eighty-eight end-stage renal disease patients on maintenance hemodialysis (100 male, mean age 49+/-29 [16-80] years, and mean duration of hemodialysis 98+/-66 [12-228] months) were enrolled in this study. Serological markers for HBV and HCV were determined with immunoenzymatic assay (ELISA) by using commercial diagnostic kits (Access and BioRad, Beckman-Coulter). HCV-RNA (Cobas Amplicor HCV kit) and HBV-DNA (Artus GmbH HBV kit) were determined quantitatively by polymerase chain reaction.


RESULTS
Among the patients screened, 25 (13.3%) had HBV infection alone and 38 (20.2%) had HCV infection alone, while seven (3.7%) had dual infection of both viruses. Serological markers for occult hepatitis B and occult hepatitis C were positive in five (2.7%) and nine (4.8%) of the patients, respectively. Isolated anti-HBc was positive in 12 (6.4%) of all patients, three (7.9%) of the patients with anti-HCV and two (40%) of the patients with occult hepatitis B. Isolated anti-HBc positivity was more frequent in patients with occult hepatitis B than in those without (40% [2/5] vs. 5.5% [10/183], p=0.002). None of the patients with HCV had occult hepatitis B.


CONCLUSIONS
Both occult and non-occult forms of HCV infection are more prevalent than HBV infection in hemodialysis patients. Especially the patients with isolated anti-HBc positivity should be tested for probable occult hepatitis B infection.
Yakaryilmaz
Fahri
F
Faculty of Medicine, Department of Gastroenterology, Kirikkale University, Kirikkale, Turkey. fahriyy67@yahoo.com
Gurbuz
Oguz Alp
OA
Guliter
Sefa
S
Mert
Ali
A
Songur
Yildiran
Y
Karakan
Tarkan
T
Keles
Hatice
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D003428:Cross Infection / Q000453:epidemiology* / Q000821:virology*; D004279:DNA, Viral / Q000097:blood / Q000302:isolation & purification; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000302:isolation & purification; D006509:Hepatitis B / Q000453:epidemiology* / Q000209:etiology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology* / Q000209:etiology*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood / Q000302:isolation & purification; D006435:Renal Dialysis / Q000009:adverse effects*; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D018937:Hepatitis C Antibodies; D012367:RNA, Viral; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase