Significado de la reactividad aislada anti-HBc como único marcador de infección de la hepatitis B

INTRODUCTION

Little is known about the clinical significance of the "anti-HBc alone" serological profile (absence of HBsAg and anti-HBs) in HBV infections. The objective of the present study was to estimate the prevalence of the anti-HBc alone immunological profile and the clinical-epidemiological characteristics of patients with this profile.

METHODS

Prospective, cross-sectional, descriptive study performed in 2002 and including patients with anti-HBc alone (HBsAg-negative, anti-HBs-negative and anti-HBc-positive). All the cases identified underwent the following microbiological tests: IgM anti-HBc, HBeAg, anti-HBe, anti-HDV, anti-HCV, anti-HIV, as well as HBV-DNA testing by qualitative nested-PCR. Furthermore, studies of serum biochemical parameters, blood counts and coagulation, as well as a clinical-epidemiological interview were performed in all patients.

RESULTS

Among 3900 patients studied, 195 (5%) presented the anti-HBc alone profile (48% were > 65 years old). Residual anti-HBs (< 10 mUI/mL) was found in 44% of cases and 33% were anti-HBe positive. HCV or HIV coinfection were seen in 38% and 8%, respectively. HBV-DNA was detected in 4.2% (5/120) of cases. Epidemiologically, detection of anti-HBc alone was casual in 60% of patients, whereas the remaining cases had a history of chronic liver disease (82% of these were anti-HCV positive). In a high percentage (63%) the transmission mechanism of HBV infection was unknown (11% intravenous drug abuser, 10% surgery, 6% transfusions).

CONCLUSION

The anti-HBc alone pattern is a frequent finding, particularly in patients > 65 years old and in HCV or HIV coinfected patients. Although HBV-DNA was detected in a small percentage of cases, this test could be indicated in certain clinical situations (liver disease, coinfection, donors). Furthermore, this profile seems to be related with HCV infection; hence, we consider anti-HCV detection necessary in all patients with anti-HBc alone.

Prevalence of hepatitis B virus markers in municipal solid waste workers in Keratsini (Greece)

AIM

To evaluate the prevalence of hepatitis B virus (HBV) markers among municipal solid waste workers (MSWWs) in Keratsini (Greece).

METHODS

We assessed in a cross-sectional study the prevalence of biological markers of HBV infection (HbsAg, anti-Hbc, anti-Hbs) and their association with exposure to waste and other socio-demographic factors in 166 municipal employees in Keratsini (Greece).

RESULTS

The prevalence of anti-Hbc (+) did differ significantly between exposed and non-exposed employees to waste. Older employees had a significantly higher prevalence of anti-Hbc (+). MSWWs who were anti-Hbc (+) were less educated than non-exposed employees. Logistic regression analysis has shown that the exposure to waste and age were independently associated with the anti-Hbc positivity.

CONCLUSION

Occupational exposure to waste is possibly associated with the acquisition of HBV infection. Immunization of MSWWs should be considered to reduce the risk of HBV infection.

Occult hepatitis B virus infection: implications in transfusion

Hepatitis B virus (HBV) presents a higher residual risk of transmission by transfusion than hepatitis C virus (HCV) or human immunodeficiency virus (HIV). While most infectious blood units are removed by screening for hepatitis B surface antigen (HBsAg), there is clear evidence that transmission by HBsAg-negative components occurs, in part, during the serologically negative window period, but more so during the late stages of infection. Donations negative for HBsAg, but positive for HBV DNA, with or without the presence of HBV antibodies, correspond to 'occult' HBV infection (OBI). The frequency of OBI depends on the relative sensitivity of both HBsAg and HBV DNA assays. It also depends on the prevalence of HBV infection in the population. OBI may follow recovery from infection, displaying antibody to hepatitis B surface antigen (anti-HBs) and persistent low-level viraemia, escape mutants undetected by the HBsAg assays, or healthy carriage with antibodies to hepatitis B e antigen (anti-HBe) and to hepatitis B core antigen (anti-HBc). Over time, in the latter situation, anti-HBe and, later, anti-HBc may become undetectable. The critical question is whether or not OBI is infectious by transfusion. All forms have been shown to be infectious in immunocompromised individuals, such as organ- or bone marrow-transplant recipients. In immunocompetent recipients, there is no evidence that anti-HBs-containing components (even at low titre) are infectious. Anti-HBc only, with HBV DNA, can be associated with infectivity, as can rare cases of HBV DNA without any serological HBV marker. If HBV nucleic acid amplification technology (NAT) is considered, the OBI viral load would usually be < 500 IU/ml, making testing of plasma pools unsuitable unless the sensitivity of NAT significantly increases by genome enrichment or test improvement.

Cadaveric renal transplantation in hepatitis B antigen–positive recipients using hepatitis B antigen–positive donor organs with lamivudine treatment

Although renal transplantation has been regarded as the best renal replacement therapy in end-stage renal disease patients, there have never been enough organ donors. Therefore, hepatitis B surface antigen (HBsAg)-negative patients are often given priority over HBsAg-positive patients. We performed cadaveric renal transplantation in six HBsAg-positive recipients given HBsAg-positive donor organs who were on lamivudine treatment. Donors were found to have normal renal function by serum and urine laboratory tests. All recipients underwent liver biopsies before transplantation; those with liver cirrhosis were excluded. All recipients were treated with 100 mg lamivudine once daily because of positive titers of hepatitis B viral (HBV) DNA (three patients), and increased levels of alanine aminotransferase (ALT) (three patients). During the follow-up period, one patient died from hepatic failure at 50 months after transplantation without deterioration of graft function. The remaining five patients showed sustained normal ALT levels. Decreases in HBV DNA titer were observed among patients who were positive before transplantation, but did not reverse to negative. Acute rejection developed in two patients: one was treated successfully with steroid pulse therapy, and the other had two bouts of acute rejection within a 33-month interval. The first was successfully treated with steroid pulse therapy, but the second failed. The four remaining patients have maintained normal renal function for a considerable time. HBsAg-positive donor organs must be used carefully in renal transplantation of HBsAg-positive recipients.

[Investigation on the alteration of hepatitis B virus (HBV) markers in liver allograft of HBV related recipients in perioperative period]

OBJECTIVE

To investigate the alteration of HBV markers in liver allograft of HBV related recipients pre and post liver transplantation under Lamivudine or combination of Lamivudine with HBIG prophylaxis and explore the mechanism of HBV de nova infection in liver allograft after orthotopic liver transplantation, as well as seek to establish a optimal prophylactic protocol.

METHODS

The serial liver biopsy specimens of 90 liver allograft and sera of 78 liver transplant recipients during operation and after 1 week, 1 month, 3 months, 6 months, 12 months, 24 months post transplantation have been collected and detected for HBV markers with enzyme-linked radioimmunoassay, fluorescent quantitative assay for HBV-DNA in serology and with immunohistochemistry stain, HBV-DNA in situ hybridization in histology for detection of HBV markers in liver allograft samples.

RESULTS

Whether recipients with active replicative or inactive replicative HBV preoperatively, none of positive HBV-DNA, HBsAg and HBcAg in 100% liver biopsy specimens with HBV-DNA hybridization in situ and immunohistochemistry stains in histology within 2 hours after reperfusion.

CONCLUSION

Whatever HBV replicative status the recipients have before surgery, no evidence of HBV particles direct invasion to the liver allograft from HBV related cirrhotics during operation under current prophylactic measures. However, the further supposed mechanism and its significance in HBV de nova infection of liver allograft remained to be disclosed further.

[Epidemiological study of hepatitis B and C in 34,336 patients operated at Hiroshima Prefectural Hospital during the period from 1993 to 2000]

BACKGROUND

We have many chances to deal with blood transfusion in the operation room, and it is important for us to pay more attention to prevent hospital infection.

METHODS

We surveyed epidemiologically the prevalence of hepatitis B virus surface antigen (HBV) and hepatitis C virus antibody (HCV) in 34,336 patients operated at Hiroshima Prefectural Hospital from April 1993 through March 2001.

RESULTS

The prevalence of HBV seropositivity was 1.8% in total, 1.6% in scheduled, and 2.5% in emergent cases. The prevalence of HCV seropositivity was 7.1% in total, 6.8% in scheduled, and 8.0% in emergent cases. Prevalences of both of them in emergent cases were higher than scheduled. The prevalence of HBV was highest (3.4%) in patients with age of 40's, and the prevalence of HCV increased with age. The prevalences of HBV and HCV were highest (4.5% and 19.0%) in the division of surgery and dialysis-kidney disease center.

CONCLUSIONS

It is important to carry out standard precautions for all patients to prevent hospital infection. Furthermore, we should pay attention to emergent operative cases and operative cases in dialyzed patients.

Expression of FasL and perforin/granzyme B mRNA in chronic hepatitis B virus infection

Cytotoxic T lymphocytes are essential components of immune responses during chronic hepatitis B (CHB). It has been known that Fas ligand (FasL) and perforin/granzyme B-based mechanisms account for all T cell-mediated cytotoxicity. In the present work, we examined the correlation between injury of the hepatocytes and mRNA expression of FasL and perforin/granzyme B in liver tissue to investigate the roles of both the FasL and the perforin/granzyme B pathways in CHB. Reverse transcription-polymerase chain reaction was used to identify intrahepatic expression of FasL and perforin/granzyme B in liver biopsy specimens from 24 patients with hepatitis B virus (HBV) infection. In addition, the transferase-mediated deoxyuridine triphosphate nick end-labelling (TUNEL) method was used to determine the degree of apoptosis. The degree of mRNA expression and apoptosis were compared with the histologic activity index (HAI) and serology, including alanine aminotransferase (ALT). Intrahepatic mRNA expression rates of FasL, perforin and granzyme B were seen in 79.2, 62.5 and 33.3% of patients, respectively, and correlated with ALT levels (P < 0.05). Intrahepatic expression of FasL and perforin mRNA were significantly correlated with HAI (P < 0.05). Also, apoptosis documented by the TUNEL assay was correlated with HAI and intrahepatic mRNA expression of FasL and perforin (P < 0.05). Our results show that the T-cell mediated perforin death pathway as well as the Fas system play important roles in liver cell injury in HBV infection and that apoptosis mediated by the Fas/FasL system is closely correlated with HAI in chronic HBV infection.

Lamivudine prophylaxis for prevention of chemotherapy-induced hepatitis B virus reactivation in hepatitis B virus carriers with malignancies

Although hepatitis B virus (HBV) reactivation in HBV carriers undergoing immunosuppressive therapy is clearly documented, the role of antiviral prophylaxis in such individuals is still controversial. The aim of this study was to determine the efficacy of lamivudine prophylaxis in HBV carriers with haemato/oncological malignancies, who receive chemotherapy. Eighteen HBV carriers with malignancy, who were candidates for chemotherapy, were enrolled. Eight subjects (three with leukaemia, four with lymphoma and one with multiple myeloma) were enrolled for prophylactic lamivudine therapy. The remaining 10 patients (six with leukaemia, three with lymphoma and one with breast cancer) were not treated with lamivudine and were used as a control. Lamivudine was administered beginning on the same day as the chemotherapy and was maintained for a year after chemotherapy was discontinued. No HBV-related mortality was observed in either group. In the lamivudine-treated group, none of the subjects had clinical, biochemical or serological evidence of HBV reactivation during the time they were receiving chemotherapy and after their chemotherapy was discontinued. In contrast, five of the 10 HBV carriers not receiving lamivudine therapy experienced a reactivation of HBV infection. This reactivation of HBV was observed during the chemotherapy in four with one individual experiencing a HBV activation 12 months after chemotherapy was discontinued. No lamivudine-related major adverse effects were observed. Hence prophylactic lamivudine treatment in HBV carriers with haemato/oncological malignancy receiving chemotherapy prevents chemotherapy-induced HBV reactivation.

Hepatitis B virus reactivation after fludarabine-based regimens for indolent non-Hodgkin's lymphomas: high prevalence of acquired viral genomic mutations

BACKGROUND AND OBJECTIVES

Chemotherapy can cause hepatitis flare-up through viral reactivation in patients who have had contact with hepatitis viruses. Few data are available on the genotype of the reactivated viruses.

DESIGN AND METHODS

In 40 consecutive adult patients with indolent non-Hodgkin's lymphoma (NHL) receiving fludarabine-based front-line chemotherapy, we performed a prospective study on viral hepatitis reactivation and analyzed the genotype of the reactivated viruses. Before chemotherapy, 4 patients were healthy carriers of hepatitis B surface antigen (HBsAg), 2 had HB core antigen antibodies (anti-HBc), 6 anti-HBs and 6 anti-HCV; 22 were seronegative.

RESULTS

Hepatitis flare-up occurred in the 4 HBsAg-positive patients and in 1 anti-HBc-positive patient at a median of 1 month (range 1-4) after chemotherapy, when the CD4/CD8 ratio was still inverted. HBV reactivation was documented in all 5 instances (HBV-DNA 2-8 x 10(6) copies/mL). Two of the 5 patients responded to lamivudine, whereas 1 died of acute liver failure and 2 had persistent severe hepatitis. HBV genome sequencing at hepatitis flare-up showed that deviation from the closest related published sequences was 1.0% and 1.1% in the 2 lamivudine-responsive patients, and 1.5%, 1.8% and 1.7% in the 3 lamivudine-resistant patients. The polymerase open reading frame (ORF) and the HBs ORF of lamivudine-resistant strains contained several novel amino acid substitutions.

INTERPRETATION AND CONCLUSIONS

These results suggest that fludarabine treatment of HBV-infected patients is frequently associated with acute hepatitis due to viral reactivation, and that lamivudine may be less effective in this situation than in other settings of immunocompromised hosts because of the emergence of resistant mutant strains.

[Diagnostic value of the radioimmunoassay and immunoenzyme assay in analysis of HBsAg in children with viral hepatitis]

The purpose of the case study was to evaluate the diagnostic efficiency of radioimmunoassay (RIA) and of immune-enzyme assay (IEA) in indicating the HBsAg in the blood of children with viral hepatitis. The study was based on a simultaneous indication of HBsAg by RIA and IEA in 98 samples of blood serum (plasma). It was shown that both assays are practically univocal in as far as the HBsAg indication within the mentioned circumstances is concerned.

The role of inducible nitric oxide synthase in a murine acute hepatitis B virus (HBV) infection model induced by hydrodynamics-based in vivo transfection of HBV-DNA

BACKGROUND/AIMS

Inducible nitric oxide synthase (iNOS) is found to have antiviral activity. Its role is evaluated using a murine acute hepatitis B virus (HBV) infection model.

METHODS

pHBV3.6 plasmid containing HBV genome was injected into mice by hydrodynamics-based in vivo transfection. HBV antigenemia and serum HBV-DNA were detected by enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction, respectively. HBV replication in liver was analyzed by Northern and Southern blot. Intrahepatic leukocytes were isolated and analyzed with flow cytometry.

RESULTS

After hydrodynamics injection of pHBV3.6, HBV genome was synthesized in the liver and HBV-DNA, as well as hepatitis B surface antigen and hepatitis B e antigen were secreted into the blood. Anti-HBV antibody responses developed afterward. A murine acute HBV infection model was established with hydrodynamics injection of non-transponase based HBV-DNA. Using this protocol in iNOS deficient or wild type B6 mice, the level of HBV transcript, replicative intermediate, and antigenemia were higher in iNOS(-/-) than in B6 mice. The intrahepatic leukocytes in iNOS(-/-) mice were also affected after transfection.

CONCLUSIONS

Our data suggests that the iNOS expression not only affects the HBV clearance, but also modulates the infiltrating leukocytes response to HBV antigens.

Metabolic risks identified by the combination of enlarged waist and elevated triacylglycerol concentration

BACKGROUND

Abdominal fat and circulating triacylglycerols increase with age, which indicates lipid overaccumulation. Enlarged waist (EW) with elevated triacylglycerols (ET) could identify adults at metabolic risk.

OBJECTIVE

Using thresholds for EW and ET observed among the youngest adults, we estimated for all adults the prevalence of combined EW and ET (EWET) and described the metabolic risks associated with EWET.

DESIGN

In a cross-sectional, weighted sample of 9183 adults, we used two-dimensional displays to provide thresholds for EW (men: > or = 95 cm; women: > or = 88 cm) and fasting ET (> or = 1.45 mmol/L) and estimated the characteristics of EWET among adults of all ages.

RESULTS

The population prevalence of EWET in 18-24-y-olds was 6%; it rose with age until age 55-74 y (prevalence: 43%) and then was lower among the elderly. Persons with EWET were more likely (P < 0.0001) to have adverse mean (+/- SEE) concentrations of risk variables in adjusted analyses (fasting insulin: 43 +/- 3 pmol/L; HDL cholesterol: -0.27 +/- 0.02 mmol/L; apolipoprotein B: 0.20 +/- 0.01 g/L; fasting glucose: 0.71 +/- 0.07 mmol/L; uric acid: 50 +/- 2 micromol/L) and to have diabetes (relative risk: 3.2) than were persons without EWET. Compared with a similar-size subpopulation with high body mass index, persons with EWET were older and had more dyslipidemia, hyperglycemia, and hyperuricemia. Compared with "metabolic syndrome," EWET identified more persons who were younger and had greater LDL-cholesterol and apolipoprotein B concentrations. Compared with "prediabetes," EWET identified more persons with hyperinsulinemia, dyslipidemia, and hyperuricemia.

CONCLUSIONS

EWET identifies a syndrome of lipid overaccumulation associated with metabolic risk and accelerated mortality after middle age. Prospective studies should evaluate this simple indicator.

[Efficacy of lamivudine in HBeAg-negative chronic hepatitis B]

The necessity of the search for new drugs to treat chronic hepatitis B (CHB) is explained by the necessity to prevent hepatic cirrhosis (HC) and hepatocellular carcinoma. Treatment of HBeAg-negative CHB rests on the same principles as of HBeAg-positive one. Efficacy of nucleoside analogue lamivudin is well studied in HBeAg-positive CHB. The aim of this study was to evaluate lamivudine efficacy in therapy of HBeAg-negative CHB. Lamivudine (epivir--150 mg/day or zeffix--100 mg/day) was given for 1 year to 10 patients (5 males, 5 females, mean age 49.5 +/- 13.5). Their blood serum contained no HBeAg but contained HBeAb and HBVDNA. Chronic hepatitis was verified morphologically in 9 patients of whom 2 had HC and 2 developing HC. Moderate activity of the disease was in 4 patients, low--in 5. All the patients had a high ALT level (150 +/- 140 U/l, 60-528 U/l, high normal value 40 U/l). ALT and HBV DNA in the serum were examined by polymerase chain reaction in the course of treatment and for 6 months after its end. To the end of the treatment a complete response (absence of HBVDNA and normalization of ALT) was achieved in 8 (80%) patients. 5 (63%) of them 2-4 months after the end of the treatment had the exacerbation with appearance of HBVDNA in the serum and elevation of ALT level. A persistent response (6 months after lamivudin treatment) was in 3 (30%) patients, in 2 of them HBsAg was not detected. Lamivudin therapy is effective in HBeAg-negative CHB. In this study a high baseline level of ALT was the factor predisposing to a lasting response to treatment.

Prevalence of hepatitis viral infection in dental patients with impacted teeth or jaw deformities

OBJECTIVE

The prevalence of infection with hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis G virus (HGV), and transfusion-transmitted viruses (TTV) was evaluated in patients with impacted teeth or jaw deformities.

STUDY DESIGN

Of 486 patients, 268 had serum samples available for retrospective TTV DNA and HGV RNA assays. In addition, the sera of 404 patients were assayed for HB surface antigen and the sera of 340 were assayed for HCV antibody.

RESULTS

HGV RNA was detected in 3 of 268 patients (1.1%), and TTV DNA was detected in 60 of 268 (22.4%). Of 404 patients, 3 had HB surface antigens (0.7%). Furthermore, 13 of 340 were HCV-seropositive (3.8%). The rate of infection was similar between patients with impacted teeth and those with jaw deformities, respectively, as follows: 1.1% versus 0%, respectively, for HBV prevalence; 4.1% versus 3.2% for HCV prevalence; 1.8% versus 0% for HGV prevalence; and 22.9% versus 21.4% for TTV prevalence.

CONCLUSIONS

Universal precautions to prevent hepatitis and TTV infection during oral surgical procedures are important.

Occult hepatitis B virus infection as a cause of cirrhosis of liver in a region with intermediate endemicity

BACKGROUND

Serological tests may fail to identify hepatitis B virus (HBV) infection as a cause of liver cirrhosis in a proportion of patients. The frequency of such occult infection in regions with intermediate HBV endemicity is not known. Such cases may be diagnosed by incremental testing for IgG anti-HBc, serum HBV DNA, and HBV DNA in liver tissue.

METHODS

We tested sera of 111 patients with cirrhosis, including 39 with history of significant alcohol ingestion, for HBsAg, anti-HBc and serum HBV DNA. In addition, in a subset of 14 patients, HBV DNA was looked for in liver tissue.

RESULTS

On HBsAg and anti-HBc testing, 66 patients had HBV infection. Serum HBV DNA testing identified HBV infection in 13 additional cases. Of 18 patients labeled as 'cryptogenic' on serological testing, HBV DNA was detected in the serum in 7 patients. Of 14 patients in whom paired liver tissue and serum specimens were tested, 4 additional patients with HBV infection were detected after liver biopsy analysis.

CONCLUSIONS

Serological tests for HBsAg and anti-HBc antibody are insensitive in identifying HBV infection in patients with liver cirrhosis. HBV DNA testing in serum and liver can help in establishing HBV infection as etiology, either alone or in addition to another cause.

10 year assessment of infant hepatitis B vaccination program, in the Loyalty Islands (New Caledonia)

OBJECTIVES OF THE STUDY

To evaluate the decrease of hepatitis B prevalence in New Caledonia 10 years after the implementation of a neonatal vaccination program and discuss the need of any booster in preadolescents.

METHOD

A survey was conducted in the Loyalty Islands, involving 593 children aged 8-11 years. Serological profiles were determined using three parameters: antibodies to core and surface antigens and HBs Ag.

RESULTS

The vaccine coverage rate is 93 and 89% of the children are protected against hepatitis B. However, 8% of them did have contact with the virus and 1.3% are carriers. Thirty-eight percent of the vaccinated children had their first injection later than the age of 3 months.

CONCLUSION

This study attests that the neonatal immunisation is accepted and followed. The prevalence reduction is not as great as expected, probably due to excess delay in primary vaccination. Hepatitis B eradication could be achieved in New Caledonia by starting immunisation at birth, and by implementing a global catch-up program among preadolescents.

A case of relapsing Guillain-Barré syndrome associated with exacerbation of chronic hepatitis B virus hepatitis

A patient with two episodes of acute polyradiculoneuropathy (Guillain-Barré syndrome) that both occurred during exacerbation of chronic hepatitis B and separated by a 2-year asymptomatic interval is described. The possible causative relation between the neuropathy and the chronic hepatitis B is discussed.

Seroprevalence of hepatitis B and C in maintenance dialysis in a public hospital in a developing country

BACKGROUND

Patients with end-stage renal disease (ESRD) on maintenance dialysis are predisposed to hepatitis B virus (HBV) infection for a number of reasons. In a similar way, the prevalence of anti-hepatitis C virus (HCV) antibodies among patients on chronic haemodialysis and peritoneal dialysis is consistently higher than in healthy populations. There are few published data on these diseases in patients undergoing maintenance dialysis in sub-Saharan Africa.

OBJECTIVE

To determine the seroprevalence of HBV and HCV in patients on maintenance dialysis.

SETTING

Renal Unit, Kenyatta National Hospital, the largest public referral and teaching hospital in Kenya.

DESIGN

Cross-sectional descriptive study.

STUDY POPULATION

All 100 patients on maintenance dialysis during the 9-month study period were evaluated.

METHOD

The following information was obtained from all the patients: socio-demographic data, date of diagnosis of ESRD and commencement of dialysis, and number of blood transfusions. Additionally, a history suggestive of hepatitis in spouses was looked for and physical examination for tattoos and other scars was carried out. Laboratory investigations included urea, electrolytes and serum creatinine, liver enzymes, hepatitis B surface antigen (HBsAg), immunoglobulin M anti-hepatitis B core antibody (IgM anti-HBc), hepatitis B e antigen (HBeAg) and anti-HCV antibodies. Student's t-test was used to assess the significance of the data collected.

RESULTS

The results were expressed as mean (+/- SD). Fifty-seven males and 43 females were studied. Mean age was 44.3 +/- 14.6 years. Ten patients (10%) had elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (> 40 U/l for both). HBsAg was found in 8 patients (8%), IgM anti-HBc in 2%, and HBeAg in none. Anti-HCV antibody was found in 5%. Six of the HBsAg-positive patients were on haemodialysis, the other 2 on continuous ambulatory peritoneal dialysis (CAPD). There was no coexistence of HBV and HCV markers. Longer duration of dialysis and the number of blood transfusions were associated with an increased seroprevalence of HBV and HCV.

CONCLUSION

There is a low seroprevalence of HBV and HCV in our dialysis population. This should not lead to complaisance in screening for these potentially lethal complications.