Oesterreicher C, Hammer J, Koch U, Pfeffel F, Sunder-Plassman
G, Petermann D, Muller C
HBV and HCV genome in peripheral blood mononuclear cells
in patients undergoing chronic hemodialysis
(Dec) 48:1967-1971 1995
The prevalence of hepatitis B virus infection in patients on dialysis has
been steadily declining due to the introduction of screening of blood
products for HBsAg, vaccination of susceptible patients, isolation of HBsAg
positive patients and a ban on reuse of dialyzers from these patients.
Consequently, hepatitis C is the major cause of hepatitis in patients on
dialysis and transplant recipients. Although tests to detect HBV DNA are
widely available for clinical use, all tests for HCV that are licenced for
clinical use are antibody tests. For both HBV and HCV, there has been a long
held suspicion that serum tests may not identify all infections. The current
study sheds new light on the potential sites of viral presence/replication.
In this study, the authors studied the presence of HBV DNA and HCV
RNA by PCR in peripheral blood mononuclear cells (PBMC) from hemodialysis
patients with an without serum markers for HCV and HBV. While none of the 67
patients were HBsAg positive, the authors detected HBV DNA in PBMC in five.
Likewise, ten of 67 patients were anti-HCV positive, and three anti-HCV
negative patients had HCV RNA (total 13). HCV RNA was detected in PBMC in
five of 13 patients with HCV markers and one of 54 patients without HCV
markers. The paper validated the reliability of these results by testing for
HBV and HCV in PBMC from healthy controls (all neagtive) and non-dialysis
patients with chronic liver disease due to HBV or HCV (majority, but not all
These results are interesting and add a new dimension to our
understanding of sites where HBV and HCV reside and possibly replicate.
Clearly, the major impact of these observations would be on:
1) Is the presence of HBV or HCV in PBMC preceded or followed by a serum
2) Are patients who are positive for HBV or HCV in PBMC, but not in the
3) Strategies to reduce the transmission of HCV and HBV in dialysis units -
is isolation of patients with serum markers alone enough?
4) Does immunosuppression due to natural events or following transplantation
lead to reappearance of infection in the serum?
Clearly, these issue need to be addressed before these findings are
translated into clinical practice.
(Brian J.G. Pereira and Teresa L. Wright)
To go back use the BACK button on your browser.
Otherwise click on the desired link to this article below:
CRF by organ system :