Integrated blood pressure control · 2019
Liddle's syndrome mechanisms, diagnosis and management.
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Mlinšek Gregor, Oblak Manca, Arnol Miha, Matičič Mojca
Аннотация
AIMS: To estimate the prevalence of anti-HBc-positive patients with functioning kidney graft, to detect the anti-HBc-positive patients in danger for hepatitis B virus (HBV) reactivation and to update Slovenian guidelines on hepatitis B follow-up, vaccination, introduction of chemoprophylaxis or treatment.
MATERIALS AND METHODS: The Slovenian national cohort of kidney transplant patients with functioning graft managed at the University Medical Center Ljubljana was included. In a cross-sectional study between March and September 2020, all included patients were screened for the presence of anti-HBc; all anti-HBc-positive patients were additionally tested for anti-HBs, HBsAg, and HBV DNA.
RESULTS: Out of a total of 778 included patients, 72 were anti-HBc positive (9.2%). Eight patients (1%) presented with asymptomatic chronic HBV infection: 6 were HBsAg-positive/HBV DNA-negative, and 2 were HBsAg-negative/HBV DNA positive. In one of the latter, HBsAg mutant variant P120QD144E was proven. By the time of the study, 12 anti-HBc-positive patients (16.6%) have already been receiving chemoprophylaxis.
CONCLUSION: The prevalence of anti-HBc-positive patients in the national cohort of kidney transplant patients in Slovenia was 9.2%. Based on the specific combination of HBV markers (anti-HBc, anti-HBs, HBsAg, HBV DNA) we stratified patients into six subgroups. Algorithm on follow-up, hepatitis B vaccination, chemoprophylaxis, or treatment is presented for each of the specific subgroups.
MATERIALS AND METHODS: The Slovenian national cohort of kidney transplant patients with functioning graft managed at the University Medical Center Ljubljana was included. In a cross-sectional study between March and September 2020, all included patients were screened for the presence of anti-HBc; all anti-HBc-positive patients were additionally tested for anti-HBs, HBsAg, and HBV DNA.
RESULTS: Out of a total of 778 included patients, 72 were anti-HBc positive (9.2%). Eight patients (1%) presented with asymptomatic chronic HBV infection: 6 were HBsAg-positive/HBV DNA-negative, and 2 were HBsAg-negative/HBV DNA positive. In one of the latter, HBsAg mutant variant P120QD144E was proven. By the time of the study, 12 anti-HBc-positive patients (16.6%) have already been receiving chemoprophylaxis.
CONCLUSION: The prevalence of anti-HBc-positive patients in the national cohort of kidney transplant patients in Slovenia was 9.2%. Based on the specific combination of HBV markers (anti-HBc, anti-HBs, HBsAg, HBV DNA) we stratified patients into six subgroups. Algorithm on follow-up, hepatitis B vaccination, chemoprophylaxis, or treatment is presented for each of the specific subgroups.