Occult hepatitis B infection in chronic hemodialysis patients: Comparison of results and concepts

We greatly enjoyed reading the excellent review by Hollinger and colleagues on occult hepatitis B infection in chronic hemodialysis (HD) patients (1). As Hollinger et al. mentioned in their review, few studies have shown the prevalence of occult hepatitis B virus (HBV) infection in HD patients. Due to the parenteral transmission of HBV, HD patients are at high risk of acquiring this virus because they need frequent blood transfusions and undergo medical procedures that accompany bleeding (2). The prevalence of occult HBV infection in these patients is between 0 to 58% (3-5). The different frequencies of occult HBV infection in HD patients may be due to variation in the prevalence of HBV infection among countries, sensitivity of molecular techniques, and the size and virological features of the study groups. In one study, we determined the rate of occult HBV infection in Iranian HD patients with isolated hepatitis B core antibody (anti-HBc) (6). Of 289 patients enrolled in this study, 18 subjects had isolated anti-HBc and HBV-DNA was detected in 50% of patients who had isolated anti-HBc. Plasma HBV-DNA load was less than 50 IU/ml in each patient. Our investigation showed that occult HBV infection was common in HD patients with isolated anti-HBc regardless of age, sex, aminotransferases levels, or length of time on dialysis (6). Our data is in agreement with the results of hollinger et al. References