Hepatitis B infection in patients with end stage renal disease: some characteristics and consequences.

Susceptibility to hepatitis B infection appears to be in part genetically determined. The HLA specificity Bw35 is commonly associated with a higher frequency of both transient and persistent hepatitis B surface antigen in the serum. Persistent hepatitis B surface antigenemia occurring in patients with end stage renal disease while on dialysis is associated with a poor prognosis and markedly decreased survival regardless of whether the individual is treated subsequently by chronic dialysis or by transplantation. We conclude that persistent hepatitis B surface antigenemia is not a contraindication to transplantation since outcome is not improved by management on hemodialysis.