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Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
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Serological and molecular characterization of hepatitis B virus infection in chronic kidney disease patients from Rio

Livia Melo Villar1, Ketlyn Araujo Fraga1, Ana Carolina da Fonseca Mendonça1

  • 1FIOCRUZ, Instituto Oswaldo Cruz, Laboratório de Hepatites Virais, Rio de Janeiro, RJ, Brazil.

The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases
|June 6, 2022
PubMed

Insights

Hepatitis B virus (HBV) infection is common in hemodialysis patients, with a high prevalence of occult HBV infection (OBI). Molecular analysis suggests nosocomial spread, highlighting the need for improved safety and vaccination strategies.

Area of Science:

  • Virology
  • Nephrology
  • Infectious Diseases

Background:

  • Patients with chronic kidney disease (CKD) on hemodialysis (HD) are at increased risk for blood-borne viral infections.
  • Hepatitis B virus (HBV) infection poses a significant global health concern in this vulnerable population.

Purpose of the Study:

  • To assess the prevalence of hepatitis B serological markers.
  • To determine the occurrence of overt and occult HBV infection (OBI) and its molecular characteristics.
  • To investigate HBV genotypes and transmission patterns in CKD patients undergoing HD in Rio de Janeiro, Brazil.

Main Methods:

  • Cross-sectional study involving 644 CKD patients undergoing HD.
  • Analysis of serum samples for HBV serological markers (HBsAg, anti-HBc, anti-HBs).
  • Detection of HBV DNA in HBsAg-reactive and "anti-HBc alone" samples; genotyping and phylogenetic analysis.

Main Results:

  • Prevalence of serological markers: HBsAg+ (5.9%), anti-HBc alone (2.8%), anti-HBc+/anti-HBs+ (30.7%), anti-HBs+ (26.6%), anti-HBc/anti-HBs/HBsAg (34.0%).
  • HBV DNA detected in 39.5% of HBsAg+ and 27.8% of "anti-HBc alone" individuals, indicating high OBI prevalence.
  • Predominant HBV genotypes were A1 (65%), D3 (20%), and A2 (15%).
  • Phylogenetic analysis suggested nosocomial HBV spread within some HD units.

Conclusions:

  • High prevalence of HBV infection and OBI in HD patients necessitates enhanced vaccination programs.
  • Identical HBV sequences and phylogenetic clustering indicate potential nosocomial transmission.
  • Continuous improvement of safety measures and laboratory surveillance is crucial to prevent HBV transmission in HD settings.

Keywords:
Chronic kidney diseaseEpidemiologyGenetic variabilityHemodialysisHepatitis B

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