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Novel Evidence on Hepatitis B Virus Infection in Dialysis

The Nobel-prize winning discovery of the hepatitis B surface antigen (HBsAg) by Blumberg and colleagues in 1965 has led to an explosive growth in information about the hepatitis B virus (HBV), development of diagnostic tests for HBV, understanding of the pathogenesis and natural history of hepatitis B, approval of antiviral treatments and development of effective vaccines. It is estimated there are currently more than 300 million HBV carriers in the world, of whom over 250,000 die annually from hepatitis B associated liver disease (1). HBV infection remains a serious complication of patients undergoing maintenance dialysis in both industrialized and developing countries. Numerous reports have shown that at present the rate of HBsAg seropositivity among dialysis patients in developed countries is low but not negligible (2-7). On the contrary, the information concerning HBV epidemiology in HD centers of the developing world is Iargely incomplete and provides different results (8-13). The aim of this review is to report the most recent acquisitions concerning the epidemiology of HBV in patients on maintenance dialysis all over the world. The application of novel techniques based on molecular technology can give nephrologists the possibility to deepen epidemiology and clinical significance of HBV in patients undergoing treatment by artificial kidney.