Prevalence and Clinical Relevance of Occult Hepatitis B Virus Infection in Patients on the Waiting List for Kidney Transplantation

Stratta, Piero; Bruschetta, Elena; Minisini, Rosalba; Barbe, Mario; Cornella, C.; Tognarelli, Giuliana; Cena, Tiziana; Magnani, C.; Fenoglio, Roberta; Toffolo, Katia; Airoldi, Aldo; Pirisi, Mario

doi:10.1016/j.transproceed.2009.03.001

Cited by 8 publications

(7 citation statements)

References 46 publications

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“…Surprisingly, 7 of the 9 had a G145R mutation and most had been vaccinated. In another study, OHB was detected in 3.3% of 300 patients on the waiting list for kidney transplantation [101]. It was more common in Asians and African‐Americans than in Caucasians and in those with chronic hepatitis C as found in other studies.…”

Section: Clinical Significance Of Occult Hepatitis Bmentioning

confidence: 57%

Occult hepatitis B virus infection: a covert operation

Hollinger

Sood

2010

Journal of Viral Hepatitis

171

173

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Detection of occult hepatitis B requires assays of the highest sensitivity and specificity with a lower limit of detection of less than 10 IU/mL for hepatitis B virus (HBV) DNA and <0.1 ng/mL for hepatitis B surface antigen (HBsAg). This covert condition is relatively common in patients with chronic hepatitis C virus (HCV) that seems to exert some influence on the replicative capacity and latency of HBV. Detection of virus-specific nucleic acid does not always translate into infectivity, and the occurrence of primer-generated HBV DNA that is of partial genomic length in immunocompetent individuals who have significant levels of hepatitis B surface antibody (anti-HBs) may not be biologically relevant. Acute flares of alanine aminotransferase (ALT) that occur during the early phase of therapy for HCV or ALT levels that remain elevated at the end of therapy in biochemical nonresponders should prompt an assessment for occult hepatitis B. Similarly, the plasma from patients with chronic hepatitis C that is hepatitis B core antibody (anti-HBc) positive (+/-anti-HBs at levels of <100 mIU/mL) should be examined for HBV DNA with the most sensitive assay available. If a liver biopsy is available, immunostaining for hepatitis B surface antigen (HBsAg) and hepatitis B core antigen (HBcAg) should be contemplated and a portion of the sample tested for HBV DNA. This is another reason for optimal collection of a specimen (e.g. two passes with a 16-guage needle under ultrasound guidance). Transmission of HBV to immunosuppressed orthotopic liver transplant recipients by donors with occult hepatitis B (OHB) will continue to occupy the interests of the transplant hepatologist. As patients with OHB may have detectable HBV DNA in serum, peripheral blood mononuclear cells (PBMC) and/or liver that can be reactivated following immunosuppression or intensive cytotoxic chemotherapy, the patient needs to be either monitored or treated depending on the pretreatment serological results such as an isolated anti-HBc reaction or a detectable HBV DNA.

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Section: Clinical Significance Of Occult Hepatitis Bmentioning

confidence: 57%

Occult hepatitis B virus infection: a covert operation

Hollinger

Sood

2010

Journal of Viral Hepatitis

171

173

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“…The prevalence of OHB infection among renal dialysis patients ranged from 0-50% in previously published studies (Goral et al 2006, Altindis et al 2007, Stratta et al 2009, Aghakhani et al 2010, Motta et al 2010, Sav et al 2010). The wide range of OHB infection prevalence could be the result of many factors, such as the use of different assays for HBV-DNA detection, viral load (VL) fluctuation in this population and different geographic HBV prevalence among the studied regions.…”

mentioning

confidence: 91%

“…It is defined as the presence of HBV-DNA in the liver with HBV-DNA detectable or not in the serum, without detectable HBsAg (Raimondo et al 2008). Some researchers have noted that OHB could be associated with the risk for the reactivation of HBV infection in patients subjected to long-term immunosuppression (Hoofnagle 2009, Stratta et al 2009). In addition, OHB may be related to chronic hepatitis of unknown aetiology, cirrhosis and hepatocellular carcinoma (Chemin & Trepo 2005, Squadrito et al 2006).…”

mentioning

confidence: 99%

Prevalence of occult hepatitis B virus infection in kidney transplant recipients

Franz¹,

Perez²,

Zalis³

et al. 2013

Mem. Inst. Oswaldo Cruz

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In this cross-sectional study, 207 hepatitis B surface antigen (HBsAg)-negative kidney transplant recipients were evaluated based on demographic and epidemiological data and on the levels of serological markers of hepatitis B virus (HBV) and hepatitis C virus infection and liver enzymes. Patients with HBV or human immunodeficiency virus infection were excluded. Sera were analysed for the presence of HBV-DNA. HBV-DNA was detected in two patients (1%), indicating occult hepatitis B (OHB) infection (the HBV-DNA loads were 3.1 and 3.5 IU/mL in these patients). The results of the liver function tests were normal and no serological markers indicative of HBV infection were detected. The prevalence of OHB infection was low among kidney transplant recipients, most likely due to the low HBsAg endemicity in the general population of the study area.

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“…The characteristics of studies evaluating the prevalence of OBI defined as HBV DNA positivity in plasma are shown in Table 5 101‐121 . The authors describe the results of the different studies according to the type of population enrolled.…”

Section: Prevalence Of Obi In Western Countriesmentioning

confidence: 99%

Prevalence of occult HBV infection in Western countries

Pisaturo

Onorato

Russo

et al. 2020

Journal of Medical Virology

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Due to a lack of standardized tests, it is difficult to obtain prevalence data and define the real impact of occult HBV infection (OBI) in Western countries. The present review article addresses the prevalence of OBI, defined as presence of hepatitis B virus (HBV) DNA in liver tissue or plasma in HBsAg‐negative subjects, in Western countries. This varies in different studies according to the different methodologies used (based on serology vs virology), to the sample analyzed for the diagnosis (liver tissue vs plasma), to the different populations studied, to the different geographical variations in the HBV spread, to the host characteristics (age, gender, risk factors for acquiring HBV infection) and to the presence of other parenteral infections (hepatitis C virus and/or human immunodeficiency virus [HIV] infections). Considering the different liver diseases analyzed, that is in patients with cryptogenic cirrhosis or advanced liver fibrosis, the prevalence of OBI ranges 4% to 38%. Considering the different populations studied, in the case of parenteral blood exposure it is about 45%, in patients with chronic hepatitis C it is estimated at about 52%, in HIV‐infected patients it ranges from 0% to 45%, in blood donors from 0% to 22.7% and in hemodialysis patients it ranges from 0% to 54%. In conclusion, OBI is a virological entity to be considered when performing the patient's evaluation for immunosuppressive diseases, liver pathologies, or for blood transfusions. Knowing the prevalence and clinical impact of OBI will allow better patient management.

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Prevalence and Clinical Relevance of Occult Hepatitis B Virus Infection in Patients on the Waiting List for Kidney Transplantation

Cited by 8 publications

References 46 publications

Occult hepatitis B virus infection: a covert operation

Occult hepatitis B virus infection: a covert operation

Prevalence of occult hepatitis B virus infection in kidney transplant recipients

Prevalence of occult HBV infection in Western countries

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