Prevalence of Occult Hepatitis B Virus in Plasma and Peripheral Blood Mononuclear Cell Compartments of Patients WithChronic Hepatitis C Infection in Tehran-Iran

Abstract

BackgroundOccult hepatitis B virus (HBV) infection (OBI) is frequently reported in patients with chronic hepatitis C virus (HCV) infection. An association between OBI and more liver damage, cirrhosis, hepatocellular carcinoma, and reduced response to interferon therapy in patients with HCV infection is suggested.ObjectivesThe aim of this study was to determine the prevalence of occult HBV, and evaluate its clinical influence on patients with chronic HCV.Patients and MethodsA cohort study including50 patients with positive results for HCV, and negative results for HBsAg tests was performed. The patients were divided into two groups: one group had positive results for both HCV and occult HBV tests (n = 18), and the other had positive results for HCV, but negative findings for occult HBV (n = 32). All were treated with PEG-IFN alpha-2a and Ribavirin. Presence of HCV RNA was followed in these patients.ResultsHBV-DNA was detected using nested-PCR in 20% of plasma and 32.6% of peripheral blood mononuclear cell (PBMC) compartments. No significant differences were observed between patients with and without occult HBV for sex, age, duration of HCV infection, histological markers, presence of anti-HBc, HCV viral load, and HCV genotype. The response rate was significantly higher in patients with positive results for HBV-DNA test compared to those with negative findings (100% vs. 71.9 %, P < 0.05).ConclusionsIn conclusion, occult HBV was found in 36% of patients with negative results for HBsAg, but positive results for HCV. Detection of HBV-DNA in both PBMCs and plasma together in comparison with plasma alone provided more true identification of OBI.The SVR rate was significantly higher in coinfected patients than mono-infected ones.

Low prevalence of occult hepatitis B virus infection in chronic haemodialysis and kidney transplant patients

“…Therefore, in order to find out whether the PBMCs are capable of transmitting the virus in CHD patients and KTxR, we performed additional testing for HBV DNA in PBMC in all patients. However, in contrast to the above‐mentioned studies, we did not detect HBV DNA in PBMC in any of our CHD or KTxR cohorts. The testing for HBV DNA in PBMCs was less sensitive than testing in serum in our study, with only positive tests in PBMCs being in the HBsAg+, non‐CHD and non‐KTx control group.…”

“…Additional testing for HBV DNA in PBMCs has been suggested to uncover occult infections not detected by serologic methods or virus determination in serum, avoiding the potential risk of a liver biopsy . Though the existence of HBV in extrahepatic tissue had been debated controversially, there is evidence that HBV can infect and replicate in PBMCs .…”

“…Though the detection of HBV DNA in the liver is the most accurate way to identify OBI, it is limited by the risk of an invasive procedure. Testing of the viral genome in peripheral blood mononuclear cells (PBMCs) has been suggested to uncover occult infections not detected by serologic methods or virus determination in serum . In this study, we aimed to investigate for the first time the prevalence of OBI in large cohorts of CHD patients and KTxR with additional testing of HBV DNA in PBMCs.…”

Influential Factors of Hepatitis B Virus cccDNA in Peripheral Blood Mononuclear Cells Among HBsAg-Positive Pregnant Females Neonates

“…Although HBV is generally considered to be hepatotropic, HBV specific nucleic acids and relative antigen can be detected in many extrahepatic tissues (20,21), and it has been proved that PBMC may be the extrahepatic place of HBV transcription and translation (22,23). In the present study, 15 mothers and 7 neonates were positive for HBV cccDNA in PBMC, which suggested that HBV can exist and be replicated in PBMC.…”

Occult hepatitis B virus infection is not associated with disease progression of chronic hepatitis C virus infection

“…The OBI prevalence in chronic HCV patients was 45.7% (42/92) in Morocco[25] and 20% (18/50) in Iran[26], while none of 100 Portuguese patients showed serum OBI[19]. A retrospective study in Taiwan showed that serum OBI prevalence as determined by nested PCR using 3 sets of primers in patients with chronic HCV infection was 14.8% (31 of 210), which did not differ from that of healthy controls (15%, 15/100), and the prevalence of OBI did not parallel the severity of liver disease (14.5% in chronic hepatitis, 8% in liver cirrhosis, and 22% in HCC)[27].…”