Occult HBV Infection May Be Transmitted through Close Contact and Manifest as an Overt Infection

Abstract

The importance of transmission of occult HBV infection (OBI) via transfusion, organ transplantation and hemodialysis has been widely recognized. However, data regarding the transmission of OBI through close contact remain limited. In this study, serum samples were obtained from a child and his parents. The child had received the standard vaccination regimen at birth and produced protective antibody. Sera were tested for HBV serological markers. Nested PCR assays were used to detect HBV DNA and the amplicons were cloned and their sequences subjected to phylogenetic analysis. The results showed that both parents had occult infections while the child had an overt infection. Twelve, eleven and nine clones, from the father, mother and son, respectively, were sequenced. Serotypes adrq+, ayw1, ayw and ayr were found in the father and ayw1, adw2 and adwq+ in the mother; adrq+ was the only serotype in son. Genotype B, subgenotype C2 and a recombinant were identified in the father and genotype B, subgenotype C5 and three recombinants were found in the mother. Subgenotype C2 was the only genotype identified in the child. A phylogenetic tree showed that all of the child’s sequences and most of the father’s sequences clustered together. However, none of mother’s sequences clustered with those of the child. The surface gene from the child and his father had the same amino acid substitution pattern (T118K, T123N and G145A). We concluded that the father was the source of the son’s HBV infection, suggesting that occult HBV infection may be transmitted through close contact and manifest as an overt infection.

Asymptomatic hepatitis B carriers who were vaccinated at birth

“…Some studies have suggested that the anamnestic immune response may play role in protection against HBV infection, although the titer of antibody has decreased below 10 mLU/mL . However, more and more studies have shown that chronic HBV carriage, detected by the presence of HBsAg in the blood, develops in some vaccines, especially in endemic regions . Whether booster doses of vaccine are necessary to maintain long‐term immunity has become an important issue.…”

Occult hepatitis B virus infection in HIV positive patients at a tertiary healthcare unit in eastern India

“…The risk of developing OBI is higher in certain populations, including HIV-positive individuals [8]. Multiple studies have investigated OBI in this high-risk cohort and reported variable prevalence rates between 0%-89.5% [9, 10].…”

Frequency of occult hepatitis B and C infections in hemodialysis patients

“…Hu ve ark. yaptıkları çalışmada anne ya da babasında okült hepatiti olan çocuklarda enfeksiyon olabileceğini ve okült hepatititin kapalı temasla da bulaşabileceğini göstermişler [6] [15]. Bizim çalışmamızda hastaların HBsAg negatif idi ve HBV-DNA saptanan 10 plasma örneğinin 7 (%70)'sinde HBV-DNA düzeyi < 6IU/ml iken 3 (%30)'ünde HBV-DNA düzeyi > 6IU/ml olarak bulundu.…”