Occult Hepatitis B Virus Infection among Egyptian Hepatitis C Virus Seropositive and Seronegative Hemodialysis Patients in Sohag Government , Upper Egypt

Abstract

Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) Infections are important and common causes of liver disease in end-stage renal failure (ESRF) in patients on haemodialysis (HD). HBV is less endemic than HCV in Egypt (ranges from 2%–7%). Although, the prevalence of HBV in haemodialysis patients has decreased significantly due to HBV vaccine and screening of blood donors, the immunosuppressive nature of renal disease often leads to chronicity of the HBV infection and an opportunity for nosocomial spread of the infection among dialysis patients. Haemodialysis patients are more risky to develop occult hepatitis B infection (OBI) due to an increased number of blood transfusions, frequent invasive procedures, difficulty in diagnosis of occult hepatitis B infection (OBI) and immunosuppression. Occult hepatitis B infection (OBI) is defined by the presence of HBV DNA in serum or liver tissue in the absence of HBsAg. Objective: to study the prevalence of occult HBV infection in HCV-positive and HCV negative patients on regular hemodialysis from Upper Egypt. Methodology: One Hundred hemodialysis patients with negative HBsAg were included in the study. These patients were divided into two groups: HCV positive and HCV negative, based on the results of anti-HCV by ELISA and HCV-RNA by PCR. HBV-DNA was studied using the real-time PCR method in both groups. Results: HBV DNA was detected in 7 of the 100 patients (7%) and HBcAb was detected in 22 patients (22%). There were no statistically significant differences in the age, sex, duration of hemodialysis, biochemical parameters, HBcAb, or HBV DNA between patients with and without HCV infection. Conclusion: The prevalence of occult HBV infection (OBI) among Egyptian hemodialysis patients is 7 % with no significant difference in the prevalence of OBI between hemodialysis patients with or without HCV infection and we suggest screening of all HD patients for OBI by testing anti-HBc and HBV DNA