Hepatitis B virus infection and the dialysis patient.
Prevention of nosocomial transmission of hepatitis B virus (HBV) has been a signal achievement in the management of chronic kidney disease. The rate of serum hepatitis B surface antigen (HBsAg) seropositivity in patients on maintenance hemodialysis in the developed world is currently low (0-10%) but outbreaks of acute HBV infection continue to occur in this setting. The prevalence of HBV infection within dialysis units in developing countries appears higher (2-20%) based on relatively few reports. Although data are limited, HBV infection in dialysis population diminishes survival; HBV viral load in HBsAg-positive dialysis patients is reportedly low and stable over time. Updated recommendations for the management of HBsAg chronic carriers on maintenance dialysis have been issued. No rigorously controlled treatment trials for treatment of hepatitis B with either interferon or lamivudine therapy in dialysis patients are currently available.
Fabrizi
Fabrizio
F
Division of Nephrology and Dialysis, Maggiore Hospital, IRCCS, Milan, Italy. fabrizi@policlinico.mi.it
Messa
Piergiorgio
P
Martin
Paul
P
D000998:Antiviral Agents / Q000627:therapeutic use; D006509:Hepatitis B / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D007121:Immunocompetence / Q000502:physiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000276:immunology / Q000628:therapy*; D006435:Renal Dialysis; D019562:Viral Load
D000998:Antiviral Agents