title: Occult hepatitis B virus infection in hemodialysis patients in Japan.
abstract: Hepatitis B surface antigen is widely used in hepatitis B virus surveillance; patients who test negative for the antigen are judged to be uninfected. However, occult hepatitis B virus infection has been confirmed with hepatitis B virus DNA at low levels in the liver and peripheral blood in patients positive for hepatitis B core antibody or hepatitis B surface antibody, even if they test negative for hepatitis B surface antigen. To investigate the prevalence of occult hepatitis B virus in hemodialysis patients, we performed cross-sectional analysis of 161 hemodialysis patients in two related institutions for hepatitis B surface antigen, hepatitis B core antibody, and hepatitis B surface antibody. Hepatitis B surface antigen, hepatitis B core antibody, or hepatitis B surface antibody was present in 45 patients (28.0%). Hepatitis B virus DNA was present in six patients (3.7%), all of whom also tested positive for hepatitis B core antibody. Hepatitis B surface antibody positivity was unrelated in only one of the six patients. Four of the six patients were positive for hepatitis B surface antigen; however, two (1.3%) of these with occult hepatitis B virus infection were found to be hepatitis B surface antigen negative. Occult hepatitis B virus infection may be missed in hepatitis B virus surveillance using hepatitis B surface antigen alone; therefore, routine hepatitis B core antibody screening is necessary. Patients who test positive for hepatitis B core antibody should undergo further hepatitis B virus DNA testing to enable accurate hepatitis B virus screening.
authors.affiliation: Saijo Clinic Takaban, Tokyo, Japan.
authors.forename: Tomokatsu
authors.initials: T
authors.lastname: Saijo
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Joki
authors.forename: Yoji
authors.initials: Y
authors.lastname: Inishi
authors.forename: Mikako
authors.initials: M
authors.lastname: Muto
authors.forename: Motohiko
authors.initials: M
authors.lastname: Saijo
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hase
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D006435:Renal Dialysis / Q000706:statistics & numerical data*
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens
keywords: Hemodialysis; Hepatitis B core antibody; Hepatitis B virus; Occult hepatitis B virus infection; Surveillance