title: Discrepancy between serological and virological analysis of viral hepatitis in hemodialysis patients.
abstract: OBJECTIVE
  Viral hepatitis is a health threat for hemodialysis (HD) patients and it may be transmitted during treatment. Some patients categorized to have viral hepatitis were found to be non-viremic. To clarify the discrepancy between the serological tests in HD patients, we conducted the study.
  
  
  METHODS
  A total of 1681 HD patients was included. Blood samples were analyzed for hepatitis B surface antigen (HBsAg) and anti-hepatitis C antibody (anti-HCV). Detection of hepatitis B virus (HBV) DNA and hepatitis C virus (HCV) RNA were performed in either HBsAg (+) or anti-HCV (+) samples. HBV DNA/HCV RNA was also measured in a subset of HBsAg (-) and anti-HCV (-) patients. Liver function tests were analyzed and compared with the serological and virological tests.
  
  
  RESULTS
  The serological tests showed that 230 patients (13.7%) were HBsAg (+) and 290 (17.3%) were anti-HCV (+). We were unable to detect HBV DNA in 97 of 230 (42.2%) HBsAg (+) patients, and HCV RNA could not be found in 76 of 290 (26.2%) anti-HCV (+) patients. In 167 HBsAg (-) patients, only one showed a trace amount of HBV DNA. None of 151 anti-HCV (-) patients showed detectable HCV RNA. The prevalence rate of viral hepatitis remains high in Taiwanese HD patients: 13.7% for HBV and 17.3% for HCV. However, virological analysis showed 42.2% non-viremic rate for HBsAg and 26.2% non-viremic rate for anti-HCV.
  
  
  CONCLUSIONS
  The findings might challenge the presently suggested principles of bed and machine dedication and the diagnosis of viral hepatitis in HD patients.
authors.affiliation: 1. Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan; ; 2. Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; ; 5. Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
authors.forename: Jer-Ming
authors.initials: JM
authors.lastname: Chang
authors.affiliation: 3. Hepatology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; ; 6. Department of Occupational Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan;
authors.forename: Chung-Feng
authors.initials: CF
authors.lastname: Huang
authors.affiliation: 1. Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan; ; 2. Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; ; 4. Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
authors.forename: Szu-Chia
authors.initials: SC
authors.lastname: Chen
authors.affiliation: 3. Hepatology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; ; 4. Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
authors.forename: Chia-Yen
authors.initials: CY
authors.lastname: Dai
authors.affiliation: 3. Hepatology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;
authors.forename: Ming-Lun
authors.initials: ML
authors.lastname: Yeh
authors.affiliation: 1. Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan; ; 3. Hepatology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; ; 4. Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
authors.forename: Jee-Fu
authors.initials: JF
authors.lastname: Huang
authors.affiliation: 7. Division of Hepatogastroenterology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan; ; 8. Department of Senior Citizen Service Management Chia Nan University of Pharmacy & Science, Tainan, Taiwan.
authors.forename: Hsing-Tao
authors.initials: HT
authors.lastname: Kuo
authors.affiliation: 3. Hepatology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; ; 4. Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
authors.forename: Wan-Long
authors.initials: WL
authors.lastname: Chuang
authors.affiliation: 3. Hepatology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; ; 4. Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
authors.forename: Ming-Lung
authors.initials: ML
authors.lastname: Yu
authors.affiliation: 2. Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; ; 5. Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
authors.forename: Shang-Jyh
authors.initials: SJ
authors.lastname: Hwang
authors.affiliation: 2. Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; ; 5. Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
authors.forename: Hung-Chun
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000368:Aged; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000472:pathogenicity; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis / Q000821:virology*; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics / Q000472:pathogenicity; D006526:Hepatitis C / Q000097:blood / Q000175:diagnosis / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients; D006435:Renal Dialysis; D014766:Viremia / Q000097:blood / Q000175:diagnosis / Q000821:virology
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens
keywords: hemodialysis; hepatitis B virus; hepatitis C virus; viremia.