Prevalence of Occult HBV Among Hemodialysis Patients in Two Districts in the Northern Part of the West Bank, Palestine

Occult hepatitis B infection is the case with
undetectable HBsAg, but positive for HBV DNA
in liver tissue and/or serum. Occult hepatitis B
infection among hemodialysis patients in Palestine
has been understudied. In this study, 148
hemodialysis patients from 2 northern districts
in Palestine, Jenin (89) and Tulkarem (59), were
investigated for occult hepatitis B, HBV, HCV
infections with related risk factors. ELISA and
PCR were used for the detection of anti-HBc and
viral DNA, respectively. The overall prevalence
of occult hepatitis B infection among the study
group was 12.5% (16/128). Occult hepatitis B
infection is more prevalent among males with
most cases (15/16) from Jenin District. About
one-third (42/132) of the hemodialysis patients
were anti-HBc positive. Approximately 27% of
the hemodialysis patients were infected with
HCV. Around 20% (28/140) were positive for
HBV DNA, but only 8.2% (12/146) of the hemodialysis
patients were positive for HBsAg. The
comparison between hemodialysis patients with
occult hepatitis B infection and those without
occult hepatitis B infection for selected risk
factors and parameters as liver Enzyme, age,
sex, HCV infection, blood transfusion, kidney
transplant, anti-HBc, and vaccination showed no
statistical significance between both categories.
Duration of hemodialysis significantly affected
the rate of HCV infection. HCV is significantly
higher in hemodialysis patients with both Diabetes
mellitus and hypertension. The prevalence
of occult hepatitis B infection among hemodialysis
patients is high; requiring stringent control
policies. HBsAg assay is insufficient test for
accurate diagnosis of HBV infection among
hemodialysis patients.