Detection of occult hepatitis B virus among chronic hepatitis C patients

Abstract

Background: Concurrent infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are increasingly recognized in patients with chronic hepatitis. In Egypt, the last decade showed a remarkable decline in HBV infection associated with remarkable rise in HCV infection. The probable impact of occult HBV in patients with chronic HCV infection has been previously investigated and the evidence suggests a possible correlation with lower response to anti-viral treatment, higher grades of liver histological changes, and development of hepatocellular carcinoma. The aim of this study was to analyze the possible influence of occult HBV infection on the clinical outcomes in chronic HCV patients and to compare conventional and real-time PCR in detecting HBV DNA among Hepatitis B surface antigen (HBsAg) negative chronic HCV. Methods: Sera collected from 100 chronic HCV patients (negative for HBsAg and positive for anti-HCV and HCV RNA) were tested for anti-HBc, anti-HBe and anti-HBs by ELISA, HCV-RNA viral load was determined by real-time PCR (TaqMan probe technique) and HBV DNA was detected with primers encoding the surface (S), core (C), polymerase (pol) and X genes. In addition, determination of liver enzymes including aspartate and alanine aminotransferases (AST, ALT) activities was performed. Results: Fifty-eight percent of the study group were positive for anti-HBc. Meanwhile, only 18 cases (18%) were positive for the polymerase gene by nested PCR and were considered as occult HBV. Among these 18 polymerase gene positive patients (occult HBV) anti-HBc was detected among 9 (50%) of cases. Different gene profiles were noticed among the 18 polymerase gene positive patients.

Genetic diversity and occult hepatitis B infection in Africa: A comprehensive review

“…OBI is frequently found in patients with chronic hepatitis C (CHC)[ 85 ]. A range of prevalence rates from 3.2% to 90.9%[ 21 , 86 ] and all studies found were conducted in Egypt[ 87 - 91 ] (Table 2 ). A low prevalence of 3.2% was found in blood donors[ 86 ], whereas the highest prevalence of 90.9% was found in patients undergoing antiviral therapy for hepatitis C[ 21 ].…”

Surveillance and impact of occult hepatitis B virus, SEN virus, and torque teno virus in Egyptian hemodialysis patients with chronic hepatitis C virus infection

“…In the present study, there was a significant association between CHC and OBI (Table 1). It is widely agreed that patients with CHC represent a category of individuals with a high prevalence of OBI (El Sheredy et al, 2015;Mahmoud et al, 2016). History of blood transfusion had no impact on OBI (Table 2), a finding that could be credited to the rigorous procedures routinely used in Egypt to make blood transfusion safe.…”

The burden of Hepatitis B virus infection in Kenya: A systematic review and meta-analysis

“…This has serious implications in that out of every 10 people who test negative for HBsAg in the country, 2 have OBI and are at serious risk of transmission. Experts have recently recommended the use of highly sensitive nested PCR or real-time PCR assays that can detect fewer than 10 copies of HBV DNA for the screening and identification of OBI ( 101 ), especially in high-risk groups such as HIV, liver disease and hemodialysis patients. Such early detection and timely treatment reduces the risk of hospital cross-infection, and prevents health care infection and unnecessary medical disputes.…”