Occult Hepatitis B Virus Among the Patients With Abnormal Alanine Transaminase

Abstract

Background:The occult hepatitis B infection (OBI) is defined as the presence of hepatitis B virus (HBV) DNA in the sera or in the liver biopsy and the absence of hepatitis B surface antigen (HBsAg) by serological test.Objectives:The current study aimed to evaluate the occult HBV infection by polymerase chain reaction (PCR) and determine HBV genotyping among the patients with abnormal alanine transaminase (ALT) in Ahvaz city, Iran.Patients and Methods:The sera of 120 patients, 54 (45%) females and 66 (55%) males, with abnormal ALT 40-152 IU were collected. All the patients were negative for HBsAg for more than one year. The patients` sera were tested by PCR using primers specified for the S region of HBV. Then the positive PCR products were sequenced to determine HBV genotyping and phylogenic tree.Results:Of these 120 subjects, 12 (10%) patients including 6 (5%) males and 6 (5%) females were found positive for HBV DNA by PCR, which indicated the presence of occult HBV infection among these patients. The sequencing results revealed that genotype D was predominant with sub-genotyping D1 among OBI patients.Conclusions:Occult hepatitis B infection is remarkably prevalent in Ahvaz, Iran, and should be considered as a potential risk factor for the transmission of Hepatitis B Virus throughout the community by the carriers.

Epidemiology, risk factors, and molecular characterization of occult hepatitis B infection among anti‐hepatitis B core antigen alone subjects

“…Among 359 patients in China, OBI was reported 10.6% . There are also some other results that are compatible with current study …”

“…27 There are also some other results that are compatible with current study. 2,23,28,29 OBI was found among 8.2% of HB vaccinated participants, which is almost near to the unvaccinated group (11.6%). The cause for this is mostly related to the escape mutants.…”

“…The occult HBV infection (OBI) is mostly defined by the presence of hepatitis B virus (HBV)‐DNA in the hepatocytes and no detection of hepatitis B surface antigen (HBsAg; viral DNA may be detected in serum or not) . The OBI could be grouped into either seropositive (positive for hepatitis B core antigen [anti‐HBc] and/or anti‐HBs) or seronegative, which are negative for all seromarkers of HBV . Antibodies against the HBV‐core protein (anti‐HBc) are evidence of a previous infection, which appear in the acute phase and persist for a lifetime .…”

Update on occult hepatitis B virus infection

“…The rate of cryptogenic liver diseases varies greatly in different regions of the world. Patients with long-term persistent ALT abnormality or with the lack of overt viral detection and autoimmune markers, have been shown to be positive for HBV DNA (OBI)[ 114 ]. While the etiology of cryptogenic liver disease remains unknown, the association of occult hepatitis C has been reported in patients with abnormal alanin aminotransaminase[ 115 ].…”

“…OBI has been regarded as an additional risk factor for progression of liver cirrhosis and HCC[ 26 , 116 ]. The prevalence of OBI in cryptogenic chronic liver disease varies from 3.88% to 55.6%[ 117 , 118 ]: in Brazil, 4.4%[ 119 ]; in China, 28.3%[ 120 ]; and in Iran, 1.9%[ 121 ], 10%[ 114 ], and India 9.5%[ 122 ]. With regard to the mentioned data, it is recommended that for improving treatment and management, the sera and PBMCs or liver biopsy of patients with cryptogenic hepatitis be screened for HBV DNA by highly sensitive molecular means before developing signs of cirrhosis or HCC.…”