Abstract: SA-PO994
Exploring the History and Outcomes of Hepatitis B Core Antibody-Positive Hemodialysis Patients Focusing on Occult Hepatitis B
Session Information
- Hemodialysis and Frequent Dialysis - V
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Chitturi, Chandrika, Henry Ford Hospital, Dearborn, Michigan, United States
- Soman, Sandeep S., Henry Ford Hospital, Dearborn, Michigan, United States
Background
Occult HepatitisB (OHB) is defined as hepatitisB core antibody (HBcAb) positivity(pos) in the absence of surface antibody (HBsAb) or surface antigen (HBsAg). The reported incidence in hemodialysis (HD) patients (pts) is 0.3% - 58%. Our study is among the first in the US to examine the history of OHB. This work is of interest in HD pts to estimate HepatitisB transmission risk.
Methods
A retrospective study of 352 HBcAb pos HD pts at a medium sized dialysis organization was performed from 2010 to 2017. Primary outcomes were the development of HBsAb pos(considered protective) or development of HBsAg pos or new HepatitisB viremia(adverse events). Univariate and multivariate regression analysis was used to study pertinent risk factors for the outcomes comparing OHB and NonOHBpts.
Results
In our study 98 (27%) pts had OHB. Each group had similar baseline demographics, while OHB pts had a higher ALT, proportion of drug use and HepatitisC compared to nonOHB pts (Tab1). There were 15 adverse events (10 viremias) in the nonOHB group. Only 1 adverse event (viremia 19 copies/mL) was seen in the OHB group (Tab2). Conversely, OHB status was a statistically significant predictor of protective HBsAb development in follow up, occurring at a 7 fold increase compared to nonOHB pts. Univariate analysis showed that history of liver disease, HepatitisC and drug use predicted HBsAb development (Tab3). History of liver disease raises risk of adverse events in an unadjusted models (P<0.05) (Tab4).
Conclusion
OHB pts at our center tend to develop protective HBsAb titers over time rather than develop viremia/antigenemia in contrast to nonOHBpts. Our study finds that OHB confers minimal risk of potential transmission of HepatitisB among HDpts.