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2002, Number 3

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Rev Mex Patol Clin Med Lab 2002; 49 (3)

Useful core M for hepatitis B patients in hemodialysis

Porras NLO, Balderas ÁR, Leija GM, Mattar OC

Language: Spanish
References: 18
Page: 148-152
PDF size: 41.62 Kb.


ABSTRACT

The hepatitis B virus has a worldwide distribution and its only important reservoir is man; it has a world prevalence of 300 million carriers of which from 1 to 1.25 million will develop hepatic cirrhosis or hepatocellular carcinoma. Risk groups exist where prevalence is greater, among them we found intravenous drug addicts, homosexuals, promiscuous heterosexuals and patients in hemodialysis program. There are structures in the virus which give place to the serologic markers HBsAg and it’s corresponding antibody HBsAc or AntiHBs. Also, there is the core antigen codified by the C gene, which is not detected free in blood, but its corresponding antibody anti-HBc is, which is an epidemiologic marker since it is maintained for life. Besides if the IgM is determined in front of IgM-HBcAc core, the most reliable marker is obtained for acute hepatitis B. Finally, the HBeAg and it’s corresponding antibody HBeAc are used as prediction markers (prognosis) of the disease. Objective: To establish the incidence of VHB serumconversion in patients of a hemodialysis program. Material and method: An observational, analytic, longitudinal and prospective study was designed which included 128 patients older than 12 years of age, serumpositive for HBcAc (IgG – IgM). A biopsy was obtained from each patient, which was analysed with an ABBOT AxSYM automatized equipment with MEIA methodology to determine HBcAc (IgG – IgM) and HBsAg. To the patients with positive HBcAc, negative HBs Ag, an HBcAc-IgM determination was realized. Results: Two patients with total HBcAc and HBcAc-IgM positive markers were found, 78 with negative markers for hepatitis B, 13 with HBcAc and anti HBs positive markers, 12 with HBsAg, HBcAc and HBeAg positive markers, 9 with HBsAg and HBcAc positive markers, 9 patients with HVC positive markers, 2 with HBcAc, anti HBs and HVC positive markers, and 3 with HBcAc and HVC positive markers. Comments: The reliability of HBcAc-IgM as an initial and acute phase marker for hepatitis B was demonstrated in our study; we found positive HBcAc- IgM in 2 patients, upon carrying out follow-up after 4-6 weeks the serum-conversion of these markers was established when finding total HBcAc, and positive HBcAc-IgM and HBsAg.


REFERENCES

  1. Miriam J, Alter Pho, and Eric E. Mast. MD, MPH. Viral Hepatitis, Gastroenterology Clines of America. 1994; 23(3): 441-445.

  2. Mc Quillan GM, Coleman PJ, Krugzon-Moran D et al. Prevalence of hepatitis B virus infection in the United States: The National Health and Nutrition Examination Surveys, 1676 trough 1994 (see comments). Am J Public Health 1999; 89: 14-18.

  3. Alter MJ, Gerenty RJ, Smallwood L et al. Sporadic non-A, non-B hepatitis frequency and epidemiology in and urban United States Population. J Infect Dis 1982; 145: 886-893.

  4. Alter MJ, Coleman, Alexander WJ et al. Importance of heterosexual activity in the transmission of hepatitis B and non-A, non-B hepatitis. JAMA 1989; 262: 1201.

  5. Francis DP, Hadler SC, Prendergast TJ et al. Occurrence of A, B in the United States: CDC Sentinel Country Hepatitis Study I. Am J Med 1984; 76: 89.

  6. Understanding your hepatitis B blood test, http://www.hepb.org/bloodtest.html

  7. CDC, hepatitis B virus infection among hemodialysis patients, morbidity and mortality weekly report, April 12, 1996; Vol.45 No. 14.

  8. CDC, Hospital infections program viral hepatitis investigations and control series November 1977. http://www.cde.gov/incidedhip/control.htm

  9. Tiollais P, Charmany P, Vyas GN. Biology of hepatitis B virus. Science 1981; 213: 406.

  10. Gerlich WH, Thomssen R. Terminología, estructura y diagnóstico de laboratorio de los virus de la hepatitis. En: Rodes J, Berhamow JP, Birchoo J, Mc Intire N y Rizzeto M (eds). Tratado de hepatología clínica. Masson-Salvat Medicina 1993: 627.

  11. Maureen M. Jonas, MD. Viral hepatitis, clinics in liver disease. 2000; 4(4): 85:871.

  12. Hillis MD, Hillis A, Walker G. Hepatitis B surface antigenemia in renal transplant recipients. JAMA 1979; 242: 329-332.

  13. Centers for disease control: public health service inter-agency guidelines for screening donors of blood, plasma, organs, tissues, and semen for evidence of hepatitis B and hepatitis C. MMVR 1991; 40 (RR-4): 1-17.

  14. Margarita Dohesa Violante. Hepatitis aguda, temas de medicina interna: hepatitis, cirrosis y cáncer hepático. Asociación de Medicina Interna de México. México: McGraw-Hill Interamericana, 1996; IV(2): 317:341.

  15. Hoofnagle JH, Gerety RJ, Barker LF. Antibody to hepatitis B virus core in man. Lancet 1973; 1: 869.

  16. Francis DP, Favero MS, Maynard JE. Transmission of hepatitis B virus. Sem Liv Dis 1981; 1: 27.

  17. Szmunes W. Recent advances in the study of the epidemiology of hepatitis B. Am J Pathol 1975; 81: 629.

  18. De la Investigación en Seres Humanos. En: Ley General de Salud. Décima Edición. México: Edit. Porrúa 1993; 424-425.




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