Hepatitis B Virus Infection and Anti-HBc (Total) Positivity in CKD Patients before Dialysis
Journal Title: Journal of Enam Meical College - Year 2016, Vol 6, Issue 3
Abstract
Background: CKD patients are associated with HBV infection both as a cause and complication of treatment. CKD patients before starting dialysis therapy are considered as a high risk group because of impaired immune response compared with healthy individuals and also other risk factors related with treatment and management. Only HBsAg marker does not always follow the presence or absence of HBV infection. Anti-HBc (total) alone positivity indicates previous exposure to HBV infection, window period and even after reactivation of resolved HBV infection. In some cases only anti-HBc positivity is interpreted as possible chronic low dose HBV infection (chronic carriage). Predialytic CKD patients were tested with three serological markers [HBsAg, anti-HBc (total) and anti-HBs] for screening HBV infection. Proper diagnosis before dialysis and knowing the infection status would help both the patient and doctor to choose proper treatment approach. Objective: This cross-sectional study was done in the CKD patients before starting dialysis therapy to find out the HBV infection and to evaluate the infection by minimal serological markers as for screening. Materials and Methods: A total of 211 patients with chronic kidney disease stage five (CKD-V) before starting dialysis therapy were included as subjects of this cross-sectional study. Among the CKD patients HBsAg was tested to see the prevalence. Other serological markers, i.e., anti-HBc (total) and anti-HBs were tested in combination with HBsAg in 89 randomly selected patients among the subjects. The patients were also tested for anti-HCV to assess co-infection. After collecting all the data of different test results analyses were done by SPSS version 15.0. Results: Among total study population 10 (4.7%) patients were found HBsAg positive. No patient was found positive for both HBsAg and anti-HCV. Among the 89 CKD patients only 2 (2.2%) patients were HBsAg positive, and only one patient (0.9%) was found positive for both anti-HBc and anti-HCV. Of them, a total of 22 (24.7%) patients were anti-HBs positive, and 35 (39.3%) patients were anti-HBc (total) positive. Of the three markers anti-HBc (total) alone positivity were in 20 (22.5%) patients. Conclusion: Data indicate a large proportion of HBV infected patients were underdiagnosed by usual screening method by HBsAg in our country. The finding of anti-HBc (total) alone cannot be clearly interpreted in terms of patient prognosis or infectivity. Patients are simply regarded as potentially infectious. Due to this uncertainty, different countries employ different procedures when faced anti-HBc alone findings. In some countries including ours the test is not performed. Since a substantial number of CKD patients with HBV infection have this antiHBc (total) positivity, standard screening procedures and precautions should be taken in blood donation, hemodialysis and for other invasive procedures to prevent transmission of infection.
Authors and Affiliations
Fareha Jesmin Rabbi, Md Morshed Alam, Kamar Rezwan, Rosy Sultana
Keywords
Related Articles
- EP ID EP36272
- DOI https://doi.org/10.3329/jemc.v6i3.29678
- Views 260
- Downloads 0
Ice-on-Eyes Test in the Diagnosis of Myasthenia Gravis
Myasthenia gravis is the most frequent autoimmune neuromuscular transmission disorder with incidence of 2-20 patients per million. Its pathophysiology is autoimmune, with acetylcholine receptor auto antibodies damaging...
Tobacco: The Silent Killer
No Abstract
Accuracy of High Resolution Sonography in Diagnosis of Fibroadenosis Compared with Histopathological Diagnosis
Background: Fibrocystic breast condition is a common, non-cancerous condition that affects premenopausal woman between 20 and 50 years of age. Because of non-specific nature of clinical presentation, diagnosis is not tha...
Admission Serum Uric Acid Levels and In-Hospital Outcomes in Patients with Acute Coronary Syndrome
Background: Uric acid is an independent risk factor for cardiovascular disease. Hospital admission for ischemic heart disease (IHD) is increasing rapidly in our country. Although studies were conducted abroad regarding...
Current Management Strategy of Non-Alcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide and is becoming the most common indication for liver transplant in the Western world. The disease spectrum varies fr...