is there a risk of transmission of hepatitis B from this patient if he is on negative HBsAG machine?
Based on several articles (see links and file below), it does seem entirely possible that there is risk of infection when a patient with HBV is placed on a HBsAg negative machine. There are a few recorded outbreaks from this very scenario in the papers below.
Let me know if these papers are not sufficient. I am happy to look for more.
http://www.ncbi.nlm.nih.gov/pubmed/12955683
http://www.ncbi.nlm.nih.gov/pubmed/25633894
If any case with chronic HBV infection (HBs Ag positive more than 6 months) serocovert to HBs Ag negative and anti HBs Ab positive and HBV DNA negative, we can transfer the case from HBV positive devices to HBV negative devices in dialysis setting. However the dialysis patients in all times should vaccinate against HBV infection and follow for ant HBs Ab too.
Yours
Alavian SM
Our policy has always been that a patient with documented HepB would continue to receive dialysis on dedicated achiness even if the surface antibody converted. We had several cases where the HepB Surface Ag turned negative but PCR was still positive. The risk of transmission is still there.
Interesting question....Agreed with Alavian
Here, we suggest to transfer those with previous hepatitis B (seroconverted to HBsAg negative with detected AntiHBs, and undetected HBV DNA) from HBV positive device to HBV negative device. And all the HD patients should be vaccinated prior.
Decision of switching to hbsag negative machine, would depend on the available facilities. If there is a facility of a designated machine for seroconverted patients, then I would go for that. If facility is not available then would continue on same HD machine.
Seems a designated machine should be used for seropositive patient .
Must remove. but two Qualitative PCR must be negative before doing so which should be at least six weeks apart.
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