Occult Hepatitis B Virus Infection in Hemodialysis Patients with Chronic Hepatitis C Virus Infection

Abstract

End-stage renal disease patients on chronic hemodialysis are at risk for both hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Viral hepatitis B and C share the same transmission route. The prevalence of hepatitis C with occult hepatitis B in hemodialysis patients remains unknown in Taiwan. The occult HBV infection may be a major clinical and infection control problem for patients under hemodialysis. We aimed to investigate the prevalence and clinical features of occult HBV infection in hemodialysis patients with chronic HCV infection. Thirty-three patients (mean age 66.2 ± 11.7 years, 20 males and 13 females), all anti-HCV-positive and HBsAg-negative under hemodialysis, were enrolled in this study. HBV-DNA was detected in 4 of 33 patients (12.1%). The viral titers of these patients were all below 35 IU/ml. The demography of age and biochemical parameters were not significantly different in patients with or without occult HBV infection. The clinical outcome did not suggest patients with occult HBV infection have higher liver cirrhosis rate (50.0% vs. 41.4%; P＞0.05). The mean HCV-RNA titer showed no difference between those with and without occult infection of hepatitis B. No new hepatitis B infection was found in the hemodialysis unit of this study over a 6-year period.Conclusions: The prevalence of occult hepatitis B infection in chronic hepatitis C patients under hemodialysis was approximate 12.1%. Occult HBV infection may have no influence on the infection control in a hemodialysis unit. The clinical impact of patients with occult hepatitis B requires further study in hemodialysis patients with chronic HCV infection in the viral hepatitis hyper-endemic areas of southern Taiwan.