DETECTION OF HEPATITIS-B VIRAL-DNA BY POLYMERASE CHAIN-REACTION IN DIALYSIS PATIENTS

The polymerase chain reaction (PCR) was used to search for hepatitis B virus (HBV) DNA sequences in the sera of 51 dialyzed patients (26 wom en, 25 men; mean age 60.5 years, range 35 to 85). Two different sets o f specific primers for HBV core and surface gene sequences were synthe sized and used for each sample. Controls were 90 HBV negative blood do nors. Results were analyzed according to other serological markers of HBV. Among the eight HBsAg positive patients (anti-HBc+: 8/8), seven w ere positive for HBV DNA. Four of eight patients were vaccinated but l ater developed acute HBs hepatitis. The presence of HBV DNA was detect ed in six of 43 HBsAg negative patients (anti-HBc+: 5/6; anti-HBs+: 3 of 6; HBeAg: 0 of 6; anti-HBe: 2 of 6). These six patients were vaccin ated and four of six developed mild and transient cytolytic hepatitis (3 before vaccination: 2 later). These results showed that HBsAg seron egative patients can be infectious. The role of HBV vaccination and/or the existence of variations in the structure of the viral genome is d iscussed.