Hepatitis B virus in patients undergoing hemodialysis: transmission risks and psychosocial reactions.

Thirteen patients undergoing hemodialysis who were carriers of hepatitis B virus (HBV) were screened for inappropriate reactions to HBV transmission risks and for emotional reactions to their renal and viral diseases. Four patients underreacted to HBV transmission risks through denial or misunderstanding. The nine remaining patients reported that their HBV, as compared with their renal disease, resulted in substantially greater restrictions in interpersonal relations and significantly greater feelings of not being accepted by others. In contrast, the nine patients reported that their renal disease, as compared with their HBV, resulted in substantially greater restrictions in leisure and work activities. Thirteen control patients undergoing hemodialysis but not having HBV did not differ from the patients with HBV in psychosocial reactions to renal disease. As shown in a one-month follow-up, counseling was effective in enhancing awareness of HBV transmission risks and in improving emotional adjustments to the renal and viral diseases.