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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2016  |  Volume : 27  |  Issue : 5  |  Page : 1047-1051
Delayed clearance of hepatitis B surface antigen and development of hepatitis B surface antibody in a chronic hemodialysis patient


1 Division of Nephrology, Greater Los Angeles Veterans Affairs Healthcare System; Department of Medicine, David Geffen School of Medicine at UCLA; Division of Nephrology, Olive View - UCLA Medical Center, Los Angeles, CA, USA
2 Department of Medicine, David Geffen School of Medicine at UCLA; Division of Nephrology, Olive View - UCLA Medical Center; Department of Medicine, Division of Nephrology, Cedars Sinai Medical Center, Los Angeles, CA, USA
3 Department of Medicine, David Geffen School of Medicine at UCLA; Division of Nephrology, Olive View - UCLA Medical Center, Los Angeles, CA, USA
4 Department of Nephrology, Kaiser Permanente, Panorama City, USA
5 Department of Medicine, David Geffen School of Medicine at UCLA; Division of Nephrology, Olive View - UCLA Medical Center; Surgical Consultative Nephrology, UCLA David Geffen School of Medicine, Director UCLA Stone Center, Los Angeles, CA, USA

Correspondence Address:
Ramy M Hanna
Cedars-Sinai Medical Center - Office Towers, 8635 West Third Street, Suite No. 495, Los Angeles, CA 90048
USA
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DOI: 10.4103/1319-2442.190886

PMID: 27752020

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The introduction of hepatitis B vaccination and infection control in 1977 has greatly decreased the prevalence of hepatitis B. Currently, approximately 2.8% of the end-stage renal disease population is hepatitis B positive with a presence in 27.7% of the USA hemodialysis (HD) units according to the Dialysis Outcomes and Practice Patterns Study data. The behavior of hepatitis B infection differs significantly between immunocompetent and immunosuppressed hosts. Immunosuppressed hosts present more subtly with complications of chronic hepatitis B infection, being more challenging to detect. It is also well known that patients with chronic infection on HD have a small chance of clearing the virus. We report here a case of a hepatitis B positive HD patient who underwent spontaneous delayed serological clearance of hepatitis B surface antigen and development of immunity via appearance of hepatitis B surface antibody. This is a rare occurrence, and the few similar reported cases will be discussed.


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