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Spontaneous clearance of hepatitis B surface antigenemia after long-term hemodialysis

Chinmay Patel1, Divya Monga, Mohini Alexander

  • 1Division of Nephrology, Department of Medicine, Hofstra North Shore-LIJ School of Medicine, NSLIJ Health System, Great Neck, New York.

Seminars in Dialysis
|October 18, 2013
PubMed

Persistent infection with the hepatitis B virus (HBV) [as indicated by chronic HBV surface antigenemia (HBsAg)] continues to be an important problem in end-stage renal disease (ESRD) patients and specifically in those receiving maintenance hemodialysis (HD). Patients on HD who are HBsAg-positive for a year have little chance of ever eliminating the virus; hence, clearance of HBsAg is a rare event in long-term HD patients. We report the case of a 62-year-old diabetic woman who was HBsAg-positive at the time she started HD and remained so until 10 years later when she became HBsAg-negative followed by the development of hepatitis B surface antibody (anti-HBs). Prior to her seroconversion, she suffered a persistent infection of her HD arteriovenous graft (AVG) that required prolonged antibiotics and several surgical procedures. We speculate that this immune stimulation contributed to her seroconversion.

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