Seroconversion rate to positivity for antibodies against core antigen of hepatitis B virus and duration of renal replacement therapy.
BACKGROUND
Prevalence of total antibodies against core antigen (anti-HBc) of hepatitis B virus (HBV) is greater in longer dialysed patients, but there are no data indicating a relationship between the higher seroconversion rate to anti-HBc positivity and longer renal replacement therapy (RRT) vintage prior to seroconversion. Our aim was to evaluate the association between RRT duration and seroconversion to anti-HBc positivity.


METHODS
An incidence of anti-HBc was evaluated in 425 anti-HBc-negative intermittent haemodialysis (IHD) patients: Group I included patients who underwent first anti-HBc testing 31 days from first IHD session, and Group II or III included patients with RRT duration < 3 or ≥ 3 years, respectively. Anti-HBc testing was repeated every 6-12 months. Sex, age, RRT duration, anti-HCV, HCV RNA, ALT, ASP, GGT, full vaccination series against HBV with developed anti-HBs titre > 10 IU/L, hepatitis history and underlying kidney diseases were used as independent variables predicting seroconversion to anti-HBc positivity.


RESULTS
Seroconversion rate to anti-HBc positivity was 2.59, 2.12 and 2.44 episodes/100 patient-years in Group I (n = 174), II (n = 170) and III (n = 80), respectively. In the entire group, there were 15 seroconversions to anti-HBc and one seroconversion to HBsAg positivity. The only variable predicting seroconversion in all HBsAg-negative patients (n = 424) was the lack of full vaccination series against HBV with developed anti-HBs titre > 10 IU/L maintained during the study (β - 0.112, P = 0.04).


CONCLUSIONS
Seroconversion rate to anti-HBc positivity is not related to duration of RRT treatment but to ineffective vaccination against HBV.
Grzegorzewska
Alicja E
AE
Department of Nephrology, Transplantology and Internal Diseases, Karol Marcinkowski University of Medical Sciences, Poznań, Poland. alicja_grzegorzewska@yahoo.com
Kaczmarek-Leki
Vanessa
V
Młot-Michalska
Monika
M
Niepolski
Leszek
L
D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006509:Hepatitis B / Q000276:immunology*; D006510:Hepatitis B Antibodies / Q000097:blood* / Q000276:immunology; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology*; D006526:Hepatitis C / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000097:blood / Q000276:immunology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000276:immunology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D017582:Renal Replacement Therapy; D012307:Risk Factors; D015996:Survival Rate; D014771:Virion / Q000276:immunology
D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D018937:Hepatitis C Antibodies