Serological and vaccination profile of hemodialysis patients during an outbreak of hepatitis B virus infection

During an outbreak of hepatitis B virus (HBV) infection in a hemodialysis u nit, patients were assessed for serological viral markers and vaccination s tatus. HBV infection was identified in 26 patients. Twenty of these were po sitive for hepatitis B surface antigen (HBsAg), and 6 were negative for HBs Ag but positive for IgM antibody to hepatitis B core (anti-HBc) and HBV DNA . The primary source of infection was not clearly identified, although 2 pa tients were suspected to be the index cases. A multiple logistic regression analysis revealed low anti-HBs titers and vaccination status to be indepen dently associated with the risk of acquiring HBV infection. Both the high p revalence of HBV infection (31%) detected in this unit and the low vaccine response (53%) observed reinforce the importance of universal and preventiv e measures in controlling HBV infection. The detection of HBV DNA in HBsAg- negative/IgM anti-HBc-positive patients emphasizes the value of anti-HBc te sting in the routine screening of HBV in hemodialysis units. Copyright (C) 2001 S. Karger AG, Basel.