TY - JOUR
T1 - Biological dynamics of hepatitis B virus load in dialysis population
AU - Fabrizi, Fabrizio
AU - Lunghi, Giovanna
AU - Alongi, Giancarlo
AU - Bisegna, Sergio
AU - Campolo, Gesualdo
AU - Mangano, Stefano
AU - Limido, Aurelio
AU - Pagliari, Bruno
AU - Tettamanzi, Fabio
AU - Ponticelli, Claudio
PY - 2003/6/1
Y1 - 2003/6/1
N2 - Background: Control of the spread of hepatitis B virus (HBV) infection in dialysis units has been one of major advances in the management of end-stage renal disease. However, the natural history of HBV in dialysis patients remains unclear. The aim of this study is to measure monthly HBV viral load (HBV DNA) in a large cohort (n = 29) of hepatitis B surface antigen (HBsAg)-positive chronic dialysis patients during 12 months. Methods: HBV DNA was measured using the Amplicor HBV Monitor Test (Roche Diagnostics, Branchburg, NJ), an in vitro assay using polymerase chain reaction nucleic acid amplification and DNA hybridization for the quantitative measurement of HBV DNA in serum. Results: We observed three HBV DNA patterns: (1) patients persistently positive by Amplicor HBV Monitor Test (persistent HBV DNA; 7 of 29 patients; 24.1%), (2) individuals with alternatively positive and negative results (intermittent HBV DNA; 18 of 29 patients; 62.1%), and (3) patients persistently negative by Amplicor HBV Monitor Test (4 of 29 patients; 13.8%). HBV viral load was greater in patients with persistent compared with intermittent HBV DNA (persistently HBV DNA positive; 2.686 × 104 copies/mL; 95% confidence interval [CI], 5.2499 × 104 to 1.8158 × 104 copies/mL) versus intermittently HBV DNA positive (1.071 × 103 copies/mL; 95% CI, 8.524 × 103 to 4.09 × 102 copies/mL; P = 0.0001). In the entire group, HBV load at study entry was low and did not change versus the end of follow-up. Conclusion: Three patterns of HBV viremia in dialysis patients over time were assessed; HBV load was not high and was relatively stable. HBsAg-positive patients who were intermittently HBV DNA positive had less HBV viral load than persistently HBV DNA-positive patients. Periodic testing for HBV DNA to assess the virological status of HBsAg-positive dialysis patients is recommended.
AB - Background: Control of the spread of hepatitis B virus (HBV) infection in dialysis units has been one of major advances in the management of end-stage renal disease. However, the natural history of HBV in dialysis patients remains unclear. The aim of this study is to measure monthly HBV viral load (HBV DNA) in a large cohort (n = 29) of hepatitis B surface antigen (HBsAg)-positive chronic dialysis patients during 12 months. Methods: HBV DNA was measured using the Amplicor HBV Monitor Test (Roche Diagnostics, Branchburg, NJ), an in vitro assay using polymerase chain reaction nucleic acid amplification and DNA hybridization for the quantitative measurement of HBV DNA in serum. Results: We observed three HBV DNA patterns: (1) patients persistently positive by Amplicor HBV Monitor Test (persistent HBV DNA; 7 of 29 patients; 24.1%), (2) individuals with alternatively positive and negative results (intermittent HBV DNA; 18 of 29 patients; 62.1%), and (3) patients persistently negative by Amplicor HBV Monitor Test (4 of 29 patients; 13.8%). HBV viral load was greater in patients with persistent compared with intermittent HBV DNA (persistently HBV DNA positive; 2.686 × 104 copies/mL; 95% confidence interval [CI], 5.2499 × 104 to 1.8158 × 104 copies/mL) versus intermittently HBV DNA positive (1.071 × 103 copies/mL; 95% CI, 8.524 × 103 to 4.09 × 102 copies/mL; P = 0.0001). In the entire group, HBV load at study entry was low and did not change versus the end of follow-up. Conclusion: Three patterns of HBV viremia in dialysis patients over time were assessed; HBV load was not high and was relatively stable. HBsAg-positive patients who were intermittently HBV DNA positive had less HBV viral load than persistently HBV DNA-positive patients. Periodic testing for HBV DNA to assess the virological status of HBsAg-positive dialysis patients is recommended.
KW - Chronic hepatitis B virus (HBV) infection
KW - Dialysis
KW - Fluctuations
KW - Hepatitis B virus viremia (HBV DNA)
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U2 - 10.1016/S0272-6386(03)00360-3
DO - 10.1016/S0272-6386(03)00360-3
M3 - Article
C2 - 12776281
AN - SCOPUS:12444333590
VL - 41
SP - 1278
EP - 1285
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
SN - 0272-6386
IS - 6
ER -