Prevalence and significance of hepatitis-B core antibodies among hepatitis B surface antigen-negative Egyptian patients on hemodialysis in Al-Gharbia governorate

Background/aims Hepatitis B virus (HBV) infection in hemodialysis (HD) patients represents a serious problem due to the immunosuppressive effect of renal failure and the susceptibility for de-novo HBV infection during HD with high morbidity and mortality. Occult hepatitis B virus infection (OBI) is defined as the presence of HBV-DNA in the serum and/or the liver in the absence of hepatitis B surface antigen (HBsAg). The strategy of combined screening for HBsAg and hepatitis B core antibody (anti-HBc) can virtually eradicate blood-transmitted HBV. The aim of this study was to evaluate the presence of anti-HBc among Egyptian regular HD adult patients and to determine the presence or absence of HBV-DNA in the serum samples from HBsAg-negative, anti-HBc-positive regular HD adult patients using the polymerase chain reaction (PCR) method to assess the magnitude of OBI in these patients. Patients and methods This cross-sectional study included 90 regular HD patients negative for HBsAg and anti-hepatitis C virus. Patients were investigated for anti-HBc, and samples of anti-HBc-positive patients were tested for HBV-DNA using real-time PCR. Results Among the 90 HBsAg-negative sera, anti-HBc was detected in 17 sera (18.9%). Eleven anti-HBc-positive patients were anti-HBs-positive. HBV-DNA was detected in seven of those 17 anti-HBc-positive patients (41.2%) (7.8% of all patients). Conclusion The overall prevalence of OBI in adult Egyptian regular HD patients is 7.8% in Al-Gharbia Governorate.