Occult Hepatitis B Virus Infection and Clinical Outcomes of Patients with Chronic Hepatitis C

Abstract

Although occult hepatitis B virus (HBV) infections in individuals without detectable hepatitis B surfaceantigen (HBsAg) may occur and have been reported to be common in patients with chronic hepatitis C, the clinical relevance remains controversial. We searched for serum HBV DNA in 210 HBsAg-negative patients with hepatitis C virus (HCV)-related liver disease (110 patients with chronic hepatitis, 50 patients with cirrhosis, and 50 patients with hepatocellular carcinoma) by PCR. Most of the patients had detectable antibodies to HBsAg or HBV core antigen. All of the 110 chronic hepatitis C patients were treated with a combination therapy consisting of interferon plus ribavirin. In addition, 100 HBsAg-negative healthy adults served as controls. Thirty-one of the 210 patients (14.8%) had HBV DNA in their sera, as did 15 of the 100 healthy controls (15%). HBV DNA was not detected in the sera of those negative for serological markers of HBV infection. In patients with chronic HCV infection, the prevalence of occult HBV infection did not parallel the severity of liver disease (14.5% in patients with chronic hepatitis, 8% in patients with liver cirrhosis, and 22% in patients with hepatocellular carcinoma). In addition, the sustained response to combination therapy against hepatitis C was comparable between patients with and without occult HBV infection (38 versus 39%). In conclusion, these data suggest that occult HBV infection does not have clinical significance in chronic hepatitis C patients residing in areas where HBV infection is endemic.Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a substantial proportion of cases of chronic liver disease including chronic hepatitis, cirrhosis, and liver cancer. It is estimated that there are 350 million HBV carriers and 170 million HCV carriers worldwide (6). HBV and HCV are transmitted parenterally and share common routes of infection; thus, infection with both viruses may occur, particularly in areas where the two viruses are endemic and among people at high risk for parenteral infections (4, 15). The diagnosis of HBV infection is usually based on the detection of hepatitis B surface antigen (HBsAg), and the disappearance of this antigen indicates the clearance of HBV (6). However, previous studies have shown that HBV DNA can be detected in patients with chronic liver disease who are negative for HBsAg but positive for antibodies to hepatitis B core antigen (anti-HBc) (1, 12, 21). More recently, this so-called occult HBV infection has frequently been identified in patients with chronic HCV infection (5,10,19), and in such patients this occult infection may be associated with more severe liver damage and even the development of hepatocellular carcinoma (HCC) (3,18,20). In addition, several studies have suggested that occult HBV infection may correlate with a lack of response to interferon treatment in patients with chronic hepatitis C (3, 5, 22). Taken together, a low-level HBV infection not only may contribute to the severity of HCV-related liver d...

Occult hepatitis B virus infection in patients with chronic liver disease due to hepatitis C virus and hepatocellular carcinoma in Brazil

“…The prevalence of occult B infection in HCV-infected patients in the present study (19.5%) was above the one reported by some authors (9,12) and below the percentages reported by others (21,28,36,38) , which can be as high as 76% (24) . It should be highlighted that the latter studies used PCR for viral DNA detection, a technique which is more sensitive than immunohistochemistry (4,12) .…”

“…In contrast, HBV DNA has been found in serum by PCR in 6.7% to 52% (13,15,16) of HBsAg-negative patients with chronic HCV infection, in 5% to 76% (7,10,30) of patients with chronic liver disease of no defi ned etiology, and in 0% (15) to 15% (21) of healthy donors.…”

Molecular Prognostic Profile of Egyptian HCC Cases Infected with Hepatitis C Virus

“…Zen (2007) found that ABCG gene was scattered or focally clustered in HCC. The overexpression of ABCG2 gene in the Egyptian HCC cases clarified the Akt high expression levels described in similar cases studied by our group (Kao et al, 2002).…”

“…DNA was extracted from frozen liver tissues according to standard protocol and was analyzed for HBV genomes with polymerase chain reaction (PCR) assays to detect the S, X and core genes as previously described (Kao et al, 2002) to exclude occult HBV infection.…”

Hepatitis B marker seroprevalence and vaccination coverage in adolescents in the City of Itajaí, State of Santa Catarina, Southern Brazil, in 2008

“…Infections with hepatitis B virus (HBV) represent a significant cause of morbidity and mortality worldwide and constitute a problem of global public health importance 1 .…”