Occult Hepatitis B Infection in End-Stage Renal Disease Patients Starting Maintenance Hemodialysis at a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Introduction: Occult hepatitis B infection is defined as the presence of the hepatitis B virus deoxyribonucleic acid in liver tissues and/or serum in the absence of serum hepatitis B Virus surface antigen. The prevalence of occult hepatitis B infection in end-stage renal disease patients is largely unknown. The aim of the study is to determine the prevalence of occult hepatitis B infection in the hemodialysis population starting maintenance hemodialysis.

Methods: A descriptive cross-sectional study was conducted in the department of Internal Medicine of a tertiary care hospital. Convenience sampling method was used; 50 consecutive end-stage renal disease patients, who started maintenance hemodialysis from March 2019 to March 2020, were enrolled in the study. The study was approved by the Institutional Review Committee of the hospital (reference number: 351/2019). Statistical Package for Social Sciences version 26.0 was used for statistical analysis.

Results: The mean age of the patients was 50.34±12.65 years, and 42 (84%) were male. About 4 (8%) patients were diagnosed having occult hepatitis B infection, 3 (6%) of them were seropositive and 1 (2%) seronegative. About 41 (82%) patients had no history of hepatitis B vaccination series before starting hemodialysis; 36 (72%) had anti-hepatitis B surface antibody titre <10 mIU/ml. About 44 (88%) patients received a blood transfusion during their hemodialysis sessions and 14 (28%) patients had a history of receiving hemodialysis at other centres.

Conclusions: Our study demonstrated a high prevalence of occult hepatitis B infection among end-stage renal disease patients starting hemodialysis.