Occult Hepatitis B Virus Infection: An Update

Saitta, Carlo; Pollicino, Teresa; Raimondo, Giovanni

doi:10.3390/v14071504

Cited by 56 publications

(64 citation statements)

References 167 publications

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“…Likely occult infections were defined as HBsAg negative, with both anti-HBc reactive and HBV NAT reactive results [ 43 ]. We assumed that anti-HBc reactivity, when neither HBsAg positive nor HBV NAT were reactive, signified resolved infections, although some occult infections are possible, as nucleic acid concentrations can be below detection [ 44 , 45 ]. For this reason, and because occult infection may be less likely to predict long term sequalae [ 46 ], we analyzed occult and resolved infections together.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B Blood Donor Screening Data: An Under-Recognized Resource for Canadian Public Health Surveillance

O’Brien

Reedman

Osiowy

et al. 2023

Viruses

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Hepatitis B surveillance is essential to achieving Canada’s goal of eliminating hepatitis B by 2030. Hepatitis B rates, association of infection with vaccine age-eligibility, and risk factors were analyzed among 1,401,603 first-time Canadian blood donors from 2005 to 2020. Donors were classified as having likely chronic or likely resolved/occult infections based on hepatitis B surface antigen, anti-hepatitis B core antigen, and hepatitis B nucleic acid test results. Likely chronically infected and control donors (ratio 1:4) participated in risk-factor interviews. The 2019 rate of likely chronic infection was 61.9 per 100,000 (95% CI 46.5–80.86) and 1449.5 per 100,000 for likely resolved/occult infections (95% CI 1370.7–1531.7). Likely chronic infections were higher in males (OR 3.2; 95% CI 2.7–3.7) and the vaccine-ineligible birth cohort (OR 1.9; 95% CI 1.6–2.2). The main risk factors were living with someone who had hepatitis (OR 12.5; 95% CI 5.2–30.0) and ethnic origin from a high-prevalence country (OR 8.4; 95% CI 5.9–11.9). Undiagnosed chronic hepatitis B may be more prevalent in Canada than currently determined by traditional passive hepatitis B reporting. Blood donor data can be useful in informing hepatitis B rates and evaluating vaccination programs in Canada.

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Section: Discussionmentioning

confidence: 99%

Hepatitis B Blood Donor Screening Data: An Under-Recognized Resource for Canadian Public Health Surveillance

O’Brien

Reedman

Osiowy

et al. 2023

Viruses

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“…Detectability of HBV DNA in serum is usually intermittent and frequently in the low viral load range (<200 IU/mL). OBI is classified as seropositive when anti-HBc and/or anti-HBs are present and less common seronegative when HBV DNA (mostly intrahepatic) is the only available marker [ 81 ]. Seropositive OBI results from HBsAg loss either after recovery from acute infection or during long-lasting chronic infection, while seronegative emerges from progressive loss of antibodies or their absence from the beginning.…”

Section: Clinical Utility Of Qanti-hbcmentioning

confidence: 99%

“…Clinical implications of OBI include the further progression of liver disease and the risk of HCC development, possible HBV transmission by blood transfusion or organ transplantation and HBV reactivation upon immunosuppression [ 81 ]. Many countries have established testing for anti-HBc in all blood donors to recognise donors with occult infection.…”

Section: Clinical Utility Of Qanti-hbcmentioning

confidence: 99%

Clinical Utility of Quantitative HBV Core Antibodies for Solving Diagnostic Dilemmas

Lazarević

Banko

Miljanovic

et al. 2023

Viruses

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The present-day management of hepatitis B virus (HBV) infection relies on constant and appropriate monitoring of viral activity, disease progression and treatment response. Traditional HBV infection biomarkers have many limitations in predicting clinical outcomes or therapy success. Quantitation of HBV core antibodies (qAnti-HBc) is a new non-invasive biomarker that can be used in solving multiple diagnostic problems. It was shown to correlate well with infection phases, level of hepatic inflammation and fibrosis, exacerbations during chronic infection and presence of occult infection. Further, the level of qAnti-HBc was recognised as predictive of spontaneous or therapy-induced HBeAg and HBsAg seroclearance, relapse after therapy discontinuation, re-infection after liver transplantation and viral reactivation upon immunosuppression. However, qAnti-HBc cannot be relied upon as a single diagnostic test to solve all dilemmas, and its diagnostic and prognostic power can be much improved when combined with other diagnostic biomarkers (HBV DNA, HBeAg, qHBsAg and anti-HBs antibodies). The availability of commercial qAnti-HBc diagnostic kits still needs to be improved. The comparison of results from different studies and definitions of universal cut-off values continue to be hindered because many methods are only semi-quantitative. The clinical utility of qAnti-HBc and the methods used for its measurement are the focus of this review.

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“…One major way in which B cells are involved in anti-HBV infection is the production of specific antibodies against diverse HBV protein components, such as antibody to hepatitis B s antigen (HBsAb), antibody to hepatitis B e antigen (HBeAb) and antibody to hepatitis B core antigen (HBcAb). HBcAb and HBeAb are considered as the marekers for the diagnosis of HBV infection, while only HBsAb can recognize and bind to HBsAg ( 36 ), thus playing an essential part in the clearance of HBsAg ( 37 ). HBsAb can not only prevent HBV from entering the body through acting as a protective neutralizing antibody to combine with free HBV virus particles, thus reducing the viral load in vivo ( 38 ), but also eliminate infected cells by mediating antigen dependent cytotoxicity and phagocytosis ( 39 ).…”

Section: Persistent Hbv Infection and Host Immune Responsementioning

confidence: 99%

Hepatitis B functional cure and immune response

2022

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Hepatitis B virus (HBV) is a hepatotropic virus, which damage to hepatocytes is not direct, but through the immune system. HBV specific CD4+ T cells can induce HBV specific B cells and CD8+ T cells. HBV specific B cells produce antibodies to control HBV infection, while HBV specific CD8+ T cells destroy infected hepatocytes. One of the reasons for the chronicity of HBV infection is that it cannot effectively activate adoptive immunity and the function of virus specific immune cells is exhausted. Among them, virus antigens (including HBV surface antigen, e antigen, core antigen, etc.) can inhibit the function of immune cells and induce immune tolerance. Long term nucleos(t)ide analogues (NAs) treatment and inactive HBsAg carriers with low HBsAg level may “wake up” immune cells with abnormal function due to the decrease of viral antigen level in blood and liver, and the specific immune function of HBV will recover to a certain extent, thus becoming the “dominant population” for functional cure. In turn, the functional cure will further promote the recovery of HBV specific immune function, which is also the theoretical basis for complete cure of hepatitis B. In the future, the complete cure of chronic HBV infection must be the combination of three drugs: inhibiting virus replication, reducing surface antigen levels and specific immune regulation, among which specific immunotherapy is indispensable. Here we review the relationship, mechanism and clinical significance between the cure of hepatitis B and immune system.

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Occult Hepatitis B Virus Infection: An Update

Cited by 56 publications

References 167 publications

Hepatitis B Blood Donor Screening Data: An Under-Recognized Resource for Canadian Public Health Surveillance

Hepatitis B Blood Donor Screening Data: An Under-Recognized Resource for Canadian Public Health Surveillance

Clinical Utility of Quantitative HBV Core Antibodies for Solving Diagnostic Dilemmas

Hepatitis B functional cure and immune response

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