The Prevalence of HBV Infection in Renal Transplant Recipients and the Impact of Infection on Graft Survival

  • Nawfal R Hussein Mail Department of Biomedical Sciences, College of Medicine, University of Zakho, Kurdistan Region, Iraq.
  • Zana SM Zana Department of Internal Medicine, College of Medicine, University of Duhok, Duhok, Iraq.
  • Nashwan MR Ibrahim Department of Surgery, College of Medicine, University of Duhok, Duhok, Iraq.
  • Mahde Saleh Assafi Department of Biology, School of Sciences, University of Duhok, Duhok, Iraq.
  • Shameran Daniel Infection Control Unit, Directorate of Health, Duhok, Iraq.
HBV, Renal transplant, Kidney transplant, Duhok, Iraq


Hepatitis B virus infection (HBV) is a leading cause of increased mortality and morbidity in renal transplant subjects. The purpose of this project was to investigate the prevalence of HBV in patients with renal transplant and compare it with the general population in Duhok city, Iraq. Then, the impact of HBV infection on graft function was evaluated. A total of 560 renal transplant subjects and 2975 volunteers were recruited in this study. All subjects were examined for HB surface antigen (HBsAg) positivity. Then, all HBsAg positive subjects were tested for viral load, alanine transaminase (ALT), aspartate aminotransferase (AST), serum creatinine and HBV profile. All HBsAg positive renal transplant subjects received treatment and were followed up for 24 months. It was found that 6/560 (1.1%) of the renal transplant subjects were HBsAg positive while 30/2975 (1.09%) of the volunteers were positive for HBsAg (P>0.05). After initiation of medications, viral load became undetected within 6 months of treatment. Serum creatinine levels were normal at the end of the study. No major side effects were recorded. The prevalence of HBV in renal transplant subjects was similar to the prevalence in general population. HBV infection did not show any negative effect on the graft function. Further study is needed with a larger sample size to explore the long term effect of the infection on graft functionality.


Shepard CW, Simard EP, Finelli L, Fiore AE, Bell BP. Hepatitis B Virus Infection: Epidemiology and Vaccination. Epidemiologic Reviews 2006;28:112-25.

Al – Juboury A, Hattem MS, AL- ASSADI M, Ali AM. Seroprevalence of Hepatitis B and C among Blood Donors in Babylon Governorate-Iraq. Medical Journal of Babylon 2010;7:

Mahmood AA, Addose SA, Hattem MS, Al- Khadi A. seroprevalence of HBs ag and Anti HCV positive blood donors in Najaf governorate Iraqi Jcomm med 2001;14:29-33.

Hussein NR, Abdullah IM, Younus OM, Taher AM, Salim AA, Shahab FI. Prevalence of HBV, HCV and HIV Infections Among Syrian Refugees in Kurdistan Region, Iraq. International Journal of Infection 2016;

Hussein NR. Prevalence of HBV, HCV and HIV and Anti-HBs antibodies positivity in healthcare workers in departments of surgery in Duhok City, Kurdistan Region, Iraq. International Journal of Pure and Applied Sciences and Technology 2015;26:70.

Tsai M-C, Chen Y-T, Chien Y-S, Chen T-C, Hu T-H. Hepatitis B virus infection and renal transplantation. World Journal of Gastroenterology : WJG 2010;16:3878-87.

Yap DYH, Chan TM. Evolution of hepatitis B management in kidney transplantation. World Journal of Gastroenterology : WJG 2014;20:468-74.

Jiang H, Wu J, Zhang X, Wu D, Huang H, He Q, et al. Kidney Transplantation from Hepatitis B Surface Antigen Positive Donors into Hepatitis B Surface Antibody Positive Recipients: A Prospective Nonrandomized Controlled Study from a Single Center. American Journal of Transplantation 2009;9:1853-8.

Hussein NR, Saleem ZSM. Successful treatment of Hepatitis C virus infection in a renal transplant patient with ribavirin and sofosbuvir: A case report. Int J Case Rep Imag 2016;7.

Hussein NR, Saleem ZSM, Balatay AA, Abd KH, Daniel S, Taha AA, et al. Seroprevalence of Helicobacter pylori Infection in Renal Transplant Recipient Attending Duhok Kidney Disease Center. Transplantation proceedings 2016;48:92-5.

Lee WC, Shu KH, Cheng CH, Wu MJ, Chen CH, Lian JC. Long-Term Impact of Hepatitis B, C Virus Infection on Renal Transplantation. American Journal of Nephrology 2001;21:300-6.

Fabrizi F, Martin P, Dixit V, Kanwal F, Dulai G. HBsAg Seropositive Status and Survival After Renal Transplantation: Meta-Analysis of Observational Studies. American Journal of Transplantation 2005;5:2913-21.

How to Cite
Hussein N, Zana Z, Ibrahim N, Assafi M, Daniel S. The Prevalence of HBV Infection in Renal Transplant Recipients and the Impact of Infection on Graft Survival. Acta Med Iran. 57(6):381-384.