De novo HBV infection in a Mayo Clinic hemodialysis population: Economic impact of reduced HBV testing and a call for changes in current US CDC guidelines on HBV testing protocols
Hemodialysis.com Author Interview:
Macaulay Onuigbo MD MSc FWACP FASN MBA
Hemodialysis.com Editor Marie Benz: What are the main findings of the study?
Our study confirmed the very low incidence rates of de novo Hepatitis B Virus (HBV) infection among ESRD patients undergoing outpatient in-center hemodialysis in the USA as reflected in our Mayo Clinic Northwestern Wisconsin Hemodialysis Units 1. Indeed, a 2009 US CDC report on the surveillance of acute viral hepatitis in the United States posted an incidence rate of just 0.2% among hemodialysis patients 2. Over 10 years, only 1 of 965 hemodialysis (0.1%) patients had de novo HBV infection 1. Furthermore, this index patient was a high risk IV drug user, known to have contracted Hepatitis C prior to starting hemodialysis in our unit 1.
Similarly, over 10 years, only 1 of 965 hemodialysis (0.1%) patients demonstrated the phenomenon of transient post-vaccination Recombinant HBsAgenemia 3. This was not unexpected since the administration of multi-dosed HBV Recombinant vaccinations are random events and the monthly blood tests for HBsAgenemia are not deliberately carried out to follow quickly after the vaccinations, which practice would otherwise increase the incidence of this phenomenon in routine ESRD care 3.
Read the rest of the interview on Hemodialysis.com