International Journal of Medical Sciences

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19 October 2017

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Int J Med Sci 2014; 11(5):436-441. doi:10.7150/ijms.8265

Research Paper

Discrepancy between Serological and Virological Analysis of Viral Hepatitis in Hemodialysis Patients

Jer-Ming Chang1,2,5, Chung-Feng Huang3,6, Szu-Chia Chen1,2,4, Chia-Yen Dai3,4, Ming-Lun Yeh3, Jee-Fu Huang1,3,4, Hsing-Tao Kuo7,8✉, Wan-Long Chuang3,4, Ming-Lung Yu3,4, Shang-Jyh Hwang2,5, Hung-Chun Chen2,5✉

1. Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan;
2. Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;
3. Hepatology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;
4. Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
5. Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;
6. Department of Occupational Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan;
7. Division of Hepatogastroenterology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan;
8. Department of Senior Citizen Service Management Chia Nan University of Pharmacy & Science, Tainan, Taiwan.

Abstract

Background and Aim: Viral hepatitis is a health threat for hemodialysis (HD) patients and it may be transmitted during treatment. Some patients categorized to have viral hepatitis were found to be non-viremic. To clarify the discrepancy between the serological tests in HD patients, we conducted the study.

Methods: A total of 1681 HD patients was included. Blood samples were analyzed for hepatitis B surface antigen (HBsAg) and anti-hepatitis C antibody (anti-HCV). Detection of hepatitis B virus (HBV) DNA and hepatitis C virus (HCV) RNA were performed in either HBsAg (+) or anti-HCV (+) samples. HBV DNA/HCV RNA was also measured in a subset of HBsAg (-) and anti-HCV (-) patients. Liver function tests were analyzed and compared with the serological and virological tests.

Results: The serological tests showed that 230 patients (13.7%) were HBsAg (+) and 290 (17.3%) were anti-HCV (+). We were unable to detect HBV DNA in 97 of 230 (42.2%) HBsAg (+) patients, and HCV RNA could not be found in 76 of 290 (26.2%) anti-HCV (+) patients. In 167 HBsAg (-) patients, only one showed a trace amount of HBV DNA. None of 151 anti-HCV (-) patients showed detectable HCV RNA. The prevalence rate of viral hepatitis remains high in Taiwanese HD patients: 13.7% for HBV and 17.3% for HCV. However, virological analysis showed 42.2% non-viremic rate for HBsAg and 26.2% non-viremic rate for anti-HCV.

Conclusions: The findings might challenge the presently suggested principles of bed and machine dedication and the diagnosis of viral hepatitis in HD patients.

Keywords: hepatitis B virus, hepatitis C virus, hemodialysis, viremia.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
How to cite this article:
Chang JM, Huang CF, Chen SC, Dai CY, Yeh ML, Huang JF, Kuo HT, Chuang WL, Yu ML, Hwang SJ, Chen HC. Discrepancy between Serological and Virological Analysis of Viral Hepatitis in Hemodialysis Patients. Int J Med Sci 2014; 11(5):436-441. doi:10.7150/ijms.8265. Available from http://www.medsci.org/v11p0436.htm