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Serum Hepatitis B virus (HBV) surface antigen quantification in HBV chronic carriers with end-stage renal disease: relationship with viral load and histological findings

Abstract

Patients with end-stage renal disease (ESRD) are at high risk for contamination with hepatitis B virus (HBV) and for the development of cirrhosis and its complications, particularly after kidney transplantation. Serum levels of HBsAg reflects the transcription of messenger RNAs produced by cccDNA and by the HBV-derived DNA sequences integrated into the host hepatocytes' genome. Therefore, HBsAg quantitation could be used to differentiate between inactive HBV carriers and patients with HBeAg-negative chronic hepatitis B, as well as to predict response to interferon, both before and during therapy.Aims: 1) To evaluate the relationship between HBsAg serum levels, viral load and histological findings in ESRD patients with HBV chronic infection; 2) To assess the influence of hemodialysis (HD) on HBsAg quantification; and 3) To compare HBsAg serum levels between ESRD patients, kidney transplantation recipients and subjects with normal renal function chronically infected with HBV.Patients and methods: This is a cross-sectional, unpaired and controlled study. HBV carriers will be distributed in three groups: Group I - ESRD patients under HD; Group II - kidney transplantation recipients; and Group III - subjects with normal renal function (controls). Each group will have approximately 50 individuals, with a total of 150 subjects. Quantitative HBsAg will be studied by automated chemiluminescent microparticle immunoassay (Architect HBsAg, Abbott, IL). HBV DNA levels will be evaluated by real-time PCR and direct sequencing will be used for HBV genotyping. (AU)

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