Sex differences in response to hepatitis B infection among patients receiving chronic dialysis treatment

Patients undergoing treatment at a community-based renal dialysis clinic were monitored monthly for hepatitis B surface antigen (HBsAg) and antibody to HBsAg (anti-HBs). Of 160 patients who began treatment HBsAg(-)/anti-HBs(-), 77 subsequently became HBsAg(+). Once HBsAg(+), males were more likely to remain HBsAg(+) indefinitely, whereas females were more likely to convert to HBsAg(-) and develop anti-HBs. This was not due to a sex difference in exposure to hepatitis B virus because only patients who became infected while undergoing treatment were included in the analysis. These data are clear evidence of a sex difference in response to hepatitis B virus, which may partially explain the greater incidence of several chronic liver diseases, including primary hepatocellular carcinoma, in males.