Delayed clearance of hepatitis B surface antigen and development of hepatitis B surface antibody in a chronic hemodialysis patient

Abstract EN

The introduction of hepatitis B vaccination and infection control in 1977 has greatly decreased the prevalence of hepatitis B.

Currently, approximately 2.8% of the end-stage renal disease population is hepatitis B positive with a presence in 27.7% of the USA hemodialysis (HD) units according to the Dialysis Outcomes and Practice Patterns Study data.

The behavior of hepatitis B infection differs significantly between immunocompetent and immunosuppressed hosts.

Immunosuppressed hosts present more subtly with complications of chronic hepatitis B infection, being more challenging to detect.

It is also well known that patients with chronic infection on HD have a small chance of clearing the virus.

We report here a case of a hepatitis B positive HD patient who underwent spontaneous delayed serological clearance of hepatitis B surface antigen and development of immunity via appearance of hepatitis B surface antibody.

This is a rare occurrence, and the few similar reported cases will be discussed.