Sir,
I read with interest the published article by Kalantari et al.[1] in your journal recently. The authors presented the zero prevalence for occult hepatitis B virus (HBV) in patients on hemodialysis in Isfahan. However, I would like to highlight some points about occult HBV among them. Occult HBV patients may be seronegative (both hepatitis B core antibody [anti-HBcAb] and hepatitis B surface [anti-HBs] antibody are negative) or seropositive (anti-HBc is positive with or without anti-HBs positivity).[2] Occult HBV is predominantly detected in patients with isolated anti-HBc (hepatitis B surface antigen [HBsAg] negative, anti-HBs negative and anti-HBc positive). Ramezani et al. showed that 1% of patients on hemodialysis with HBsAg-negative had occult HBV with positive HBV DNA in their serum without considering their HBcAb status.[3] It seems that if the authors would done in all hemodialysis HBsAg-negative group, the result would be clearer and it seems that the occult HBV had underestimated in their study group. However, currently available evidence suggests a relatively high prevalence of occult hepatitis B in hemodialysis patients. Conventional serologic testing used in most hemodialysis centers is not able to identify the occult infection.[4]
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References
- 1.Kalantari H, Ferdowsi F, Yaran M. Prevalence of occult hepatitis B virus infection in hemodialysis patients in Isfahan, Iran. Adv Biomed Res. 2016;5:151. doi: 10.4103/2277-9175.188487. [DOI] [PMC free article] [PubMed] [Google Scholar]
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