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Spontaneous Clearance of Hepatitis B Surface Antigenemia After Long‐term Hemodialysis
Author(s) -
Patel Chinmay,
Monga Divya,
Alexander Mohini,
Magoon Sandeep,
Bernstein David,
Wagner John D.,
Mattana Joseph
Publication year - 2013
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12154
Subject(s) - medicine , seroconversion , hemodialysis , hepatitis b virus , gastroenterology , hbsag , hepatitis b , antibody , immunology , virus
Abstract Persistent infection with the hepatitis B virus ( HBV ) [as indicated by chronic HBV surface antigenemia ( HB sAg)] continues to be an important problem in end‐stage renal disease ( ESRD ) patients and specifically in those receiving maintenance hemodialysis ( HD ). Patients on HD who are HB sAg‐positive for a year have little chance of ever eliminating the virus; hence, clearance of HB sAg is a rare event in long‐term HD patients. We report the case of a 62‐year‐old diabetic woman who was HB sAg‐positive at the time she started HD and remained so until 10 years later when she became HB sAg‐negative followed by the development of hepatitis B surface antibody (anti‐ HB s). Prior to her seroconversion, she suffered a persistent infection of her HD arteriovenous graft ( AVG ) that required prolonged antibiotics and several surgical procedures. We speculate that this immune stimulation contributed to her seroconversion.