Occult Hepatitis B Infection in Haemodialysis Patients: A Hidden Threat in Cameroon

Hepatitis B is a major public health concern, but what happens when the virus hides undetected in the body? A recent study conducted at Yaoundé University Hospital in Cameroon sheds light on occult hepatitis B infection (OBI)—a condition where the virus remains active despite standard tests showing no signs of infection. This silent threat is particularly dangerous for haemodialysis patients, who are already at high risk due to frequent blood exposure and weakened immune systems.

Key Findings from the Study

1. High Prevalence of Hidden Infections

• Among 41 haemodialysis patients tested, 7.3% (3 patients) had detectable hepatitis B surface antigen (HBsAg).
• Shockingly, 26.3% (10 patients) who tested negative for HBsAg were found to carry HBV DNA—confirming occult infection.

1. Genotype E Dominance and a Critical Mutation

• Genetic sequencing revealed that all detected OBI cases belonged to genotype E, the most common strain in West and Central Africa.
• A mutation (P127L) in the virus’s « a determinant » region was identified, which may help the virus evade immune detection.

1. Low Vaccination Rates and High Exposure

• Only 1 out of 41 patients had completed the full hepatitis B vaccination schedule.
• 68.3% showed signs of past HBV exposure (anti-HBc positive), indicating widespread virus circulation in this vulnerable group.

Why Does This Matter?

Occult hepatitis B is a stealthy danger—patients may unknowingly transmit the virus, and undiagnosed infections can lead to severe liver damage, especially in immunosuppressed individuals. For haemodialysis patients, who already face life-threatening complications, OBI adds another layer of risk.

What Needs to Be Done?

• Improved Screening: Standard HBsAg tests are not enough—PCR-based HBV DNA testing should be routine for high-risk groups.
• Better Vaccination Coverage: Haemodialysis patients need stronger adherence to vaccination protocols, including booster doses.
• Further Research: The P127L mutation’s role in immune evasion requires deeper investigation to guide future diagnostics and treatments.

Final Thoughts

This study highlights a critical gap in hepatitis B management, especially in resource-limited settings like Cameroon. With 1 in 4 haemodialysis patients silently carrying the virus, healthcare systems must adapt to detect and prevent OBI before it leads to irreversible harm.

Have you or someone you know been affected by hepatitis B? Share your thoughts in the comments below.

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Source: Bamzok et al. (2024). Occult Hepatitis B Infection in Patients Undergoing Haemodialysis in Yaoundé (Cameroon). Health Research in Africa. Read the full study here.

Disclaimer: This blog post is based on a scientific study and is for informational purposes only. Consult a healthcare professional for medical advice.