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World J Gastroenterol. Dec 7, 2007; 13(45): 6037-6040
Published online Dec 7, 2007. doi: 10.3748/wjg.v13.i45.6037
Hepatitis B viral infection in maintenance hemodialysis patients: A three year follow-up
Ya-Li Cao, Shi-Xiang Wang, Zuo-Min Zhu
Ya-Li Cao, Shi-Xiang Wang, Department of Blood Purification, Beijing Chaoyang Hospital, Affiliate of Capital Medical University, Beijing 100020, China
Zuo-Min Zhu, Department of Clinical Laboratory, Beijing Chaoyang Hospital, Affiliate of Capital Medical University, Beijing 100020, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Shi-Xiang Wang, Department of Blood Purification, Beijing Chaoyang Hospital, Affiliate of Capital Medical University, Beijing 100020, China. tzg1219@hotmail.com
Telephone: +86-10-85231455
Received: June 6, 2007
Revised: September 5, 2007
Accepted: October 15, 2007
Published online: December 7, 2007
Abstract

AIM: To observe the prevalence of hepatitis B virus (HBV) infection in maintenance hemodialysis patients.

METHODS: Eighty-eight hemodialysis patients who had been receiving hemodialysis regularly for an average of 39.45 ± 7.57 (range from 36 to 49) mo were enrolled in this study. HBV markers were measured in these patients before hemodialysis and in 100 healthy controls by the chemiluminescent microparticle immunoassay (CMI) method in order to compare the incidence of HBV infection in hemodialysis patients versus normal healthy people. All patients were then divided into two groups: patients positive for HBV markers (i.e. those positive for HBsAg, anti-HBc, HBeAg, anti-HBe, with or without positive anti-HBs) (n = 33), and patients negative for HBV markers (including those only positive anti-HBs) (n = 55). The following information was obtained for all patients: socio-demographic data, number of blood transfusions and some laboratory investigations. After 39.45 ± 7.57 mo follow-up, HBV markers were measured in these patients by CMI.

RESULTS: The incidence of HBV infection in maintenance hemodialysis patients was 37.5%, which was higher than in controls (9%). In the patients positive for HBV markers, there were 13 patients (39.4%) who had a history of blood transfusion, which was more than the number [12 (21.8%), P = 0.04] of patients negative for HBV markers. Eight of the 88 patients negative for HBV markers turned out to be positive, while three of the 33 patients positive for HBV markers turned out to be negative. There was no cirrhosis of the liver or hepatoma occurring in these patients.

CONCLUSION: Maintenance hemodialysis patients have a higher risk of HBV infection than the average population. The number of blood transfusions is associated with an increased prevalence of HBV. While it is hard for hemodialysis patients to eliminate HBV, the prognosis of patients with positive HBV markers is good.

Keywords: Hepatitis B virus; Infection; Hemodialysis patients; Maintenance; Prevalence