Antibodies to core antigen of hepatitis B virus in patients on renal replacement therapy: association with demographic, clinical and laboratory data.
BACKGROUND
Total antibodies to core antigen of hepatitis B virus (anti-HBc) are a marker for previous or current infection with hepatitis B virus (HBV). Our aim was to examine the prevalence and incidence of anti-HBc in relation to demographic, clinical and laboratory data of patients treated with intermittent hemodialysis (IHD).


METHODS
Predictors for anti-HBc positivity were evaluated in prevalence IHD patients with negative testing for surface antigen of HBV (HBsAg, n = 1,105) using the stepwise backward regression analysis. Patients starting IHD (n = 336) were introduced into the one-year prospective study evaluating seroconversion for anti-HBc.


RESULTS
Anti-HBc positivity (19.5% of all patients) was predicted by lack of vaccination against HBV with developed protective titer of antibodies to HBsAg (beta = 0.592, p = 0.000), vintage of renal replacement therapy (RRT, beta = 0.206, p = 0.000), history of hepatitis (beta = 0.101, p = 0.000), and activity of alanine aminotransferase (beta = 0.057, p = 0.037). In 85 prospective patients who finished first IHD year, seroconversion rate for anti-HBc was 1.23 episodes/100 patient-years.


CONCLUSIONS
Lack of or not effective vaccination against HBV is the strongest predictor for prevalence of anti-HBc positivity in RRT patients. Periodical determination of anti-HBc, usually not required, may be helpful in evaluation of current epidemiological status and risk for further HBV infection in dialysis centers.
Grzegorzewska
Alicja E
AE
Department of Nephrology, Transplantology and Internal Diseases, Poznań University of Medical Sciences, Poznań, Poland. alicja_grzegorzewska@yahoo.com
Kurzawska-Firlej
Danuta
D
Ratajewski
Włodzimierz
W
Frankiewicz
Dorota
D
Niepolski
Leszek
L
Kaczmarek
Andrzej
A
D000328:Adult; D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000453:epidemiology*; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution
D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens