Kim So Mi, Kim Hyun Woo, Lee Ji Eun, Lee Eun Kyoung, Shin Hyun Deok, Song Il Han
Division of Nephrology, Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea.
Hemodial Int. 2015 Jan;19(1):66-71. doi: 10.1111/hdi.12214. Epub 2014 Sep 5.
Occult hepatitis B virus (HBV) infection is defined as the presence of HBV DNA in the liver tissue and/or serum of subjects seronegative for hepatitis B surface antigen (HBsAg). Occult HBV infection of hemodialysis (HD) patients is informative in terms of virus transmission, reactivation after kidney transplantation, and the progression of liver disease. However, there is little detailed information about occult HBV infection in the context of virus endemicity. We tried to investigate the seroprevalence and clinical features of occult HBV infection in HD patients in HBV-endemic regions. We enrolled a total of 159 HD patients and 121 apparently healthy subjects at Dankook University Hospital and Jeju National University Hospital in Korea. HBsAg, anti-HBs, anti-HBc, and anti-hepatitis C virus (HCV) antibody levels were measured by radioimmunoassay. Serum levels of HBV DNA were measured by real-time polymerase chain reaction. The seroprevalence of occult HBV infection was 1.3% in HD patients and 2.5% in the healthy controls. This difference was not significant. The HBV load in all subjects with occult infection was <116 copies/mL, and all were positive for IgG anti-HBc, regardless of the presence of anti-HBs. None of the occult HBV-infected subjects were co-infected with HCV. One of the 2 HD patients with occult HBV infection had no history of blood transfusion. In this HBV-endemic region, the seroprevalence of occult HBV infection in HD patients with a very low viral load was not significantly different from that in apparently healthy subjects.
隐匿性乙型肝炎病毒（HBV）感染的定义为，在乙型肝炎表面抗原（HBsAg）血清学阴性的受试者的肝组织和/或血清中存在HBV DNA。血液透析（HD）患者的隐匿性HBV感染对于病毒传播、肾移植后病毒再激活以及肝病进展具有重要意义。然而，在病毒流行的背景下，关于隐匿性HBV感染的详细信息却很少。我们试图调查HBV流行地区HD患者隐匿性HBV感染的血清流行率和临床特征。我们在韩国檀国大学医院和济州国立大学医院共招募了159名HD患者和121名明显健康的受试者。通过放射免疫分析法检测HBsAg、抗-HBs、抗-HBc和抗丙型肝炎病毒（HCV）抗体水平。通过实时聚合酶链反应检测血清HBV DNA水平。HD患者隐匿性HBV感染的血清流行率为1.3%，健康对照者为2.5%。这一差异不显著。所有隐匿感染受试者的HBV载量均<116拷贝/mL，无论是否存在抗-HBs，所有受试者的IgG抗-HBc均为阳性。隐匿性HBV感染的受试者均未合并HCV感染。2例隐匿性HBV感染的HD患者中，有1例无输血史。在这个HBV流行地区，病毒载量极低的HD患者隐匿性HBV感染的血清流行率与明显健康的受试者相比无显著差异。
