Int J Med Sci 2020; 17(15):2299-2305. doi:10.7150/ijms.49540 This issue

Research Paper

Occult Hepatitis B Virus Infection in Maintenance Hemodialysis Patients: Prevalence and Mutations in “a” Determinant

Yun Tang1, Xiangqin Liu2, Xiangheng Lu3, Qiang He1, Guisen Li1, Yang Zou1,✉

1. Department of Nephrology, Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China.
2. Department of Clinical Laboratory, Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China.
3. School of Medicine, Nanchang University, Nanchang 330047, China.

This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Citation:
Tang Y, Liu X, Lu X, He Q, Li G, Zou Y. Occult Hepatitis B Virus Infection in Maintenance Hemodialysis Patients: Prevalence and Mutations in “a” Determinant. Int J Med Sci 2020; 17(15):2299-2305. doi:10.7150/ijms.49540. Available from https://www.medsci.org/v17p2299.htm

File import instruction

Abstract

Background: Occult hepatitis B virus infection (OBI) is defined as undetectable serum hepatitis B surface antigen (HBsAg) with detectable HBV-DNA in the serum or liver. Patients with maintenance hemodialysis (MHD) are at a high risk of OBI. The prevalence of OBI in MHD patients in China is not well evaluated. In this study, we aim to assess the prevalence of OBI in MHD patients in Sichuan Province, Southwest of China and investigate the mutations in the “a” determinant of HBsAg.

Methods: A total of 330 patients undergoing MHD at Sichuan Provincial People's Hospital were enrolled. Serum samples were collected for ELISA assay to test the serological markers of HBV infection, real-time PCR assay to identify the presence of HBV-DNA, and nested PCR plus sequencing analysis to investigate the gene mutations.

Results: In a total of 330 MHD patients, we found that the prevalence of OBI was 4.2% (7/165) in the test group, 2.1% (7/330) in the overall dialysis cohort. After a follow-up study of 7 MHD patients with OBI for 2 years, 2 (isolated HBcAb+) of them were still detectable for HBV-DNA. By sequencing analysis, we revealed mutations at the “a” determinant of HBsAg, including Q129R, T131N, M133S, F134L and D144E. The Q129R and M133S mutations were first reported.

Conclusions: Our study clarifies the prevalence of OBI in MHD patients in Sichuan Province(4.2% in the test group, 2.1% in the overall dialysis cohort), and demonstrate the mutations of Q129R and M133S in the “a” determinant of HBsAg for the first time.

Keywords: Occult hepatitis B virus infection(OBI), maintenance hemodialysis, prevalence, amino acid mutation, genotype