Superinfection with Hepatitis C Virus in Hemodialysis Patients with Hepatitis B Surface Antigenemia: Its Prevalence and Clinical Significance in Taiwan

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Abstract
A survey of hepatitis B surface antigen (HBsAg) and antibodies against hepatitis C virus (anti-HCV) in 173 patients undergoing hemodialysis in Taiwan revealed that 15 (9%) patients were positive for both HBsAg and anti-HCV, 106 (61%) were positive for anti-HCV alone, and 14 (8%) were positive for HBsAg alone. Most HBsAg positivity was acquired before the onset of hemodialysis. Anti-HCV positivity, however, was mainly acquired via the hemodialysis procedure. Patients with dual markers were younger (43.7 ± 3.3 years old, p = 0.0274), had the longest period on hemodialysis (6.6 ± 1.3 years, p sAg and anti-HCV had an increased incidence of chronicity (5/15 vs. 2/38; p sAg alone, however, did not increase the incidence of liver dysfunction. The presence of anti-HCV alone was only associated with a greater elevation of serum alanine aminotransferase (44.2 ± 5.5 vs. 19.1 ± 2.5 U/l; p sAg-positive hemodialysis patients in Taiwan. As the coexistence of anti-HCV and HBsAg is associated with more severe liver dysfunction, it is urgent to devise effective methods to prevent HCV circulation in a hemodialysis environment – especially in a hepatitis B virus endemic area such as Taiwan.

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