prevalence of overt and occult hepatitis b virus infections among 135 haemodialysis patients attending a haemodialysis centre at al-nasiriyah city, iraq

Background and objectives: the prevalence of hepatitis b virus (hbv) infection among haemodialysis (hd) patients has been well documented. in addition to overt infection, occult hepatitis b infection exists in which a patient who is diagnosed seronegative for hepatitis b surface antigen (hbsag) shows positive hbv-dna on using more accurate molecular methods. this study aims to determine the prevalence of overt and occult hbv infection among the hd patients who had attended al-nasiriyah dialysis centre during a two-month period. materials and methods: serological qualitative detection of hbsag by rapid test (strips), enzyme immunoassay (eia, hbsag) and molecular (real-time polymerase chain reaction (real-time pcr)) was conducted for quantitative detection of hbv in hd patients’ serum. results: the prevalence of overt hbv infection among hd patients was 3.7%. the viral load of hbv positive patients was ranging from 5.85 × 101 to 2.16 × 10^6 copies/ml of serum with median (7.4 × 10^5 copies/ml). occult hepatitis b was not detected in any of the seronegative hd patients (0%). overt infection was found more in males (80%) than females (20%) (p<0.05). similarly, infection was found to be higher among patients who had blood transfusions (80%) than those who had not (20%) with statistical significant p<0.05. although not statistically significant, the mean duration of hd was higher among hbv positive hd patients (17.6) than hbv negative hd patients (14.3). a dual infection of hbv and hcv was not detected in this study. conclusion: nosocomial transmissions at hd centres and blood transfusion are important risk factors. besides serological screening, real-time pcr offers a safeguard against the spread of overt and occult hbv infection and determines the viral load of the positive patients.