The Relationship of Hepatits B Core Antibody Positivity with Demographic and Laboratory Parameters in Hemodialysis Patients (original) (raw)
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Annals of Hepatology, 2013
Background. Recent studies have demonstrated that prevention of hepatitis B virus (HBV) transmission remains a challenge in hemodialysis (HD) patients. The aim of this study is to explore factors which increase the possibility of occult HBV (OHB) infection in patients under HD in Iran. Material and methods. Among 2188 cases who spent an average of 60.2 ± 61.1 months under HD, we selected 103 cases with isolated antihepatitis B virus core antibody (anti-HBc) and 231 controls without any HBV, hepatitis D virus (HDV) and hepatitis C virus (HCV) serologic markers. Socio-demographic data, past medical history, and clinical signs and symptoms were assessed. Results. The frequency of checking hepatitis B serologic markers was 15.3%. The rate of OHB infection in HD patients who were monitored for their HBV markers was 4.9%. Cases with isolated anti-HBc had significantly higher percentage of positive HBV DNA [odds ratio: OR (95% confidence interval: 95% CI) = 12.1 (1.4-105)], visual disturbances [OR (95% CI) = 1.8 (1.1-3.03)], history of diabetes mellitus [OR (95% CI) = 2.1 (1.3-3.5)], higher age, higher age when dialysis started and were mostly married, illiterate, disabled and retired. Diabetes mellitus was the only independent predictor of HBV DNA status in cases with isolated anti-HBc. Conclusion. In our region, OHB infection is prevalent among hemodialysis patients and displays a direct correlation with factors which are age related except diabetes mellitus. Thus, the presence of isolated anti-HBc should prompt the clinician to evaluate a possible OHB infection especially when it is detected in conjunction with a history of diabetes mellitus.
2011
Introduction: To evaluate the relationship between various biochemical, nutritional and demographic factors with immune response to hepatitis B vaccine in maintenance hemodialysis (HD) patients. Material and Methods: A retro-prospective study was carried out on 68 patients undergoing maintenance hemodialysis .Patients were vaccinated against hepatitis B virus with an intramuscular hepatitis B vaccination schedule, 40 micrograms at 0, 1, and 6 months. We also selected 32 age matched normal healthy persons who had vaccinated against hepatitis B previously to compare the antibody production with HD patients. Results: The value of serum antibody level against hepatitis B surface antigen ( HBs) in hemodialisis patients and healthy persons were 35±55(median=5.5) and 135±71 (median=175) mIU/ml respectively. There was a significant deference between mean serum antibody level against HBs antigen of hemodialysis patients and normal subjects (p<0.001), there were not any significant differences of antibody production against HBs antigen between males and females or diabetic and non diabetics. There were no correlation between serum antibody level against HBs-Ag and serum albumin and also with body mass index. There were not significant correlation between anti-HBs antibody level and age, amounts of hemodialysis, duration of dialysis, dialysis adequacy, serum ferritin level and serum lipids. There were not also significant correlation between anti-HBs antibody level and serum parathormone, calcium, phosphorus, serum hemoglobin and hematocrit level. Conclusion: In this study, there was not significant correlation between serum antibody level against hepatitis B surface antigen and various nutritional and demographic factors of patients under regular hemodialysis.
Hepatitis B status in hemodialysis patients
Arquivos de Gastroenterologia
BACKGROUND: Patients on chronic dialysis present a high prevalence of hepatitis B virus infection. Despite infection-control practices, surveillance of serological markers, and hepatitis B vaccination, there are still outbreaks of the disease in dialysis centers. OBJECTIVE: This study aims to assess the serologic and vaccination status for hepatitis B in hemodialysis patients. METHODS: This cross-sectional study assessed serologic markers and hepatitis B vaccination status of chronic kidney disease patients on regular dialysis program in São Carlos, SP, Brazil. Patients without information about hepatitis B status (anti-HBc, HBsAg and anti-HBs) were referred for testing. Individuals with uncertain or incomplete immunization status and without serological conversion (anti-HBs <10mIU/mL) were referred to vaccination, with adverse effects monitored. RESULTS: The study included 130 from a total of 181 dialysis patients. The majority were male (63.8%), mean age 53.9 years. All patient...
Isolated anti-hbc and occult HBV infection in dialysis patients
Nephro-urology monthly, 2015
Occult Hepatitis B virus (HBV) infection (OBI) is defined as the presence of HBV-DNA in the liver or serum with undetectable hepatitis B surface antigen (HBsAg). Hemodialysis (HD) patients are at risk of acquiring parenterally transmitted infections. The aim of this study was to assess the prevalence of OBI in HD patients. A hundred HBsAg negative HD patients were included in this study from main dialysis units in Tehran, Iran. HBsAg, hepatitis B surface antibody (anti-HBs), hepatitis B core antibody (anti-HBc) and liver enzymes levels were examined in all subjects. The presence of HBV-DNA was determined in plasma samples using real-time PCR. A hundredpatients with a mean age of 58.5 ± 16.1 years were enrolled in this study. In total, 56.7% were male and 43.3% female. Anti-HBs, anti-HBc, anti-HCV and anti-HIV were detected in 56.7%, 2%, 5.2% and 1% of patients, respectively. Isolated anti-HBc was detected in 2% of cases. HBV-DNA was detected in 1% of HBsAg negative patients. This st...
Association of response to hepatitis B vaccination and survival in dialysis patients
BMC Nephrology, 2012
Background: The status of immunocompromised patients is well recognized in end stage renal disease (ESRD). As described recently, this acquired immune dysfunction in the uremic milieu may be one of the main pathogenic factors for mortality in ESRD. The aim of this study was to determine the relationship between the immune response following a hepatitis B vaccination (HBV vaccination) and the survival of maintenance dialysis patients. Methods: A total of 156 patients (103 on hemodialysis and 53 on continuous ambulatory peritoneal dialysis) were recruited. After receiving a full dose of the HBV vaccination, all patients were followed up for to 5 years to evaluate the association of patient survival, cause of mortality, and immune response.
Good response to HBsAg vaccine in dialysis patients is associated with high CD4+/CD8+ ratio
International Urology and Nephrology, 2012
Objective Chronic renal failure is accompanied by various abnormalities of innate and acquired, cellular and humoral immunity. We aimed to investigate whether positive Candida skin test results, CD4? and CD8?, before the first dose of vaccination could be a predictor for antibody response to hepatitis B vaccination and the relation of these parameters with hepatitis B antibody levels 1 month after the last dose of vaccination. Materials and methods The present study was carried out in 57 dialysis patients. All patients received recombinant hepatitis B vaccine (40 lg) given intramuscularly in the deltoid muscle in a fourdose schedule at 0, 1, 2, and 6 months. Candida skin test and lymphocyte subsets (CD4? and CD8?) were determined before the first dose of vaccination and 1 month after the fourth inoculation of hepatitis B vaccine. Results Ten patients (17.5%) were non-responders (HBsAb \ 10 IU/L), while 47 patients (82.5%) were responders (HBsAb C 10 IU/L). However, 29 patients (50.9%) were weak responders (HBsAb:10-100 IU/L), 18 patients (31.6%) good responders (HBsAb [ 100 IU/L), which was determined 1 month after the fourth dose of vaccination. Thirty-nine patients (68.4%) and 44 patients (77.2%) were anergic to Candida skin test before the first dose and 1 month after fourth inoculation of hepatitis B vaccine, respectively. There was no relationship between Candida skin test and response to hepatitis B vaccination. Mean age was lower, and CD4?/CD8? ratio measured both before and after vaccination was higher in good responders compared with that of weak responders and that of nonresponders. Females were better responders than males. Conclusion High skin test anergy rate and low seroconversion rate after hepatitis B vaccination are important problems in patients on dialysis. Females, younger patients, and patients with higher CD4?/ CD8? ratio have better HBsAb antibody response to hepatitis B vaccination.
Hepatitis B surface antigenemia in chronic hemodialysis patients: effect of hepatitis B immunization
American Journal of Gastroenterology, 2002
OBJECTIVE: Hemodialysis patients with hepatitis B surface antigen (HBsAg) are considered to have the hepatitis B virus (HBV) and are segregated to limit transmission. However, transient de novo HBsAg has been identified in hemodialysis patients shortly after vaccination. Our hypothesis is that immunization rather than actual HBV infection is the most common cause of de novo HBsAg among hemodialysis patients.
Asian Journal of …, 2009
Background:In spite of the progress made in the prevention of transfusion transmitted infections over the last few years, transmission of HBV infection through transfusion of HBsAg negative blood has been documented.Objectives:To assess the frequency and clinical significance of anti-HBc in multitransfused hemodialysis patients.Materials and Methods:One hundred and forty-three hemodialysis patients who had been receiving blood regularly with an average of 39.4 ± 7.579 months on hemodialysis were enrolled in this study. HBV markers (HBsAg, anti-HBc, anti-HBs) were measured in these patients and in 100 healthy controls by the ELISA technique. The following data were obtained for all patients: socio demographic data, number of blood transfusions and some laboratory investigations.Results:In our patients, anti-HBc was positive in 9%, anti HBs in 7%, coexistant HbsAg/anti-HBc in 2.8% and anti HBc/anti HBs in 18.9%, meanwhile no patients were positive for HBsAg alone. In patients with only positive anti-HBc, the levels of anti-HBc were significantly related to abnormal results of liver function. In patients with positive anti-HBs/anti-HBc (n = 27), 18 patients had abnormal liver function, and 9 patients had normal liver function with no significant difference between them.Conclusions:This study suggests that hepatitis B prevalence in our multitransfused hemodialysis patients is far in excess of that anticipated on the basis of HBsAg prevalence. Absence of HBsAg in the blood of hemodialyzed patients may not be sufficient to ensure lack of circulating HBV, and isolated positivity of anti-HBc may be a possible indicator of active hepatitis B infection.
Post Vaccination Evaluation of Anti-HBsAg Antibody Titers among Haemodialysis Patients
Hepatitis B virus (HBV) is the second most common viral infection which poses threat of infection among health care workers and those individuals treated for various debilitated conditions in hospital settings. Patients undergoing haemodialysis are at a greater risk of acquiring HBV infection. Although HBV vaccination has been in use for almost three decades, it is not completely certain about its efficacy in long-term protection. Few studies in the past have emphasized the need for evaluation of anti-HBsAg antibody titers among high risk groups that include patients undergoing haemodialysis. Studies in the past have also noted that few vaccinated group do not respond to HBV vaccine and that few other group of vaccinated individuals develop inadequate antibody titers. The present study evaluated the antibody titers among haemodialysis patients and health care workers.