Quantitation of HBV cccDNA in anti-HBc-positive liver donors by droplet digital PCR: A new tool to detect occult infection

Data on the prevalence of occult HBV infection (OBI) in Western Europe and in Northern America are few; hence, we conducted a systematic review and meta‐analysis. All studies included had to fulfil the following inclusion criteria: (a) they investigated the prevalence of OBI (HBV DNA in liver tissue in HBsAg‐negative subjects), (b) were carried out in Western Europe and in Northern America; (c) were available as a full‐text manuscript, (d) written in English and (e) published up to December 2018. The exclusion criteria were as follows: (a) meta‐analyses, letters, reviews, meeting abstracts or editorial comments; (b) studies investigating HBsAg‐positive patients; (c) those investigating OBI outside Western Europe and in Northern America; and (d) to avoid small sample bias in the random‐effects model, those enrolling less than five subjects. Thirty‐four studies met the inclusion criteria, allowing a meta‐analysis on 2729 patients. The overall prevalence of OBI was 34% (95% CI = 26%‐42%), 28% (CI 95%: 12%‐48%) in 329 subjects without chronic liver disease and 35% (95% CI 26%‐44%) in 2400 patients with chronic liver disease. The prevalence of OBI was 51% (95% CI 40%‐62%) in the 823 anti‐HBc‐positive subjects and 19% (95% CI 10%‐30%) in the 1,041 anti‐HBc‐negative subjects. Evaluating the data from 17 studies comparing anti‐HBc‐positive and negative subjects, the prevalence of OBI was higher in the 641 anti‐HBc‐positive subjects than in the 1041 anti‐HBc‐negative (prevalence ratio = 2.29; 95% CI = 1.61‐3.26, P < .001). This meta‐analysis showed that in HBsAg‐negative subjects the prevalence of OBI was high and was associated with anti‐HBc positivity.

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Qualit Y a Ss E Ss Mentmentioning

confidence: 99%

See 1 more Smart Citation

An estimation of the prevalence of occult HBV infection in Western Europe and in Northern America: A meta‐analysis

Pisaturo

Onorato

Russo

et al. 2019

“…However, to date there is no accepted assay nor commercial kit for the accurate quantification of HBV cccDNA. A large number of homologous HBV DNA, especially rcDNA, may affect the accuracy of cccDNA detection …”

Section: Application Of Viral Markers In Chb Clinical Practicementioning

confidence: 99%

Insights for clinical diagnostic indicators of virus and host in chronic hepatitis B infection

Guo

Zeng

et al. 2020

Covalently closed circular DNA (cccDNA), which is stably present in the nucleus of hepatocytes, is an important indicator for evaluating antiviral efficacy. Since cccDNA quantification requires an invasive procedure, serum biological markers that can effectively reflect the transcriptional activity of intrahepatic virus and the efficacy of treatment are required. Here, from the aspects of virus and host, we outline the focus of clinical research of HBV in recent years, including HBV RNA, empty virus, hepatitis B core‐related antigen and changes in the immune response. We briefly discuss their significance in predicting disease activity and monitoring treatment response in chronic hepatitis B. On this basis, some issues worthy of attention in laboratory diagnosis are proposed.

“…Thus, even without signs of inflammation or detectable replication, HBV infection may become dormant, but can reactivate and lead to severe inflammation and even death . One study found occult infection based on cccDNA measurement in 52% of liver donors, classified as anti‐HBc‐positive . Unfortunately, cccDNA measurement is not feasible in clinical practice.…”

Section: Viral Markers After “Functional Cure” Of Hbv Infection?mentioning

confidence: 99%

New viral biomarkers for Hepatitis B: Are we able to change practice?

Siederdissen

Maasoumy

Cornberg

2018

The management of chronic hepatitis B virus (HBV) infection is challenged by its varying natural course and its stealthy nature. Not all HBV-infected patients will develop complications of infection; however, it is of utmost importance to identify patients who are at risk and require antiviral treatment and/or close surveillance. Hepatic inflammation and quantification of HBV DNA have guided treatment decisions in the last decade, and these guided interventions have been shown to reduce liver-related complications and death. Data on the quantification of additional HBV markers such as hepatitis B surface antigen (HBsAg), hepatitis B core-related antigen (HBcrAg) and hepatitis B virus RNA (HBV RNA) have accumulated in recent years. Here, we review the current evidence of how to use these markers and discuss open issues that require additional research.