Role of occult hepatitis B virus in chronic hepatitis C patients with flare of liver enzymes

Selim, Heba S.; Abou-Donia, Hadia A.; Taha, Hossam A.; El-Azab, Gasser; Bakry, Ahmed F.

doi:10.1016/j.ejim.2010.12.001

Cited by 26 publications

(16 citation statements)

References 35 publications

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“…Also, the result of normal liver enzymes in our patients with OBI were comparable to many studies that failed to demonstrate the association between OBI and elevation of liver enzymes in patients with HCV (17, 24, 27, 28). However, other studies reported a direct correlation between the presence of OBI and flare liver enzymes (29, 30). In the present study, seven patients (4 patients who achieved an EVR and 3 a non EVR) with negative results for HBV-DNA in first plasma, showed appearance of HBV-DNA in second plasma following clearance or reduction of serum HCV-RNA levels due to HCV antiviral therapy.…”

Section: Discussionmentioning

confidence: 84%

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

et al. 2013

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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.

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Section: Discussionmentioning

confidence: 84%

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

et al. 2013

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“…Regarding the clinical consequences of occult HBV infection in patients with chronic hepatitis C, studies have indicated the negative influence of cryptogenic HBV infection on histologic activity and severity of liver disease and HCC, possibly by integration with the host genome or synthesis of pro-oncogenic proteins by free intrahepatic HBV genomes (34, 36, 37, 38). Also, in HCV- infected patients, occult HBV infection may contribute to increased plasma HCV-RNA loads and liver transaminase levels (39, 40). On the other hand, some studies have reported that OHB occult HBV infection does not affect the pathological findings in the liver, changes in aminotransferase levels, or occurrence of HCC in patients with chronic HCV (32, 41, 42).…”

Section: Resultsmentioning

confidence: 99%

Occult Hepatitis B (OBH) in Clinical Settings

et al. 2012

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ContextOccult hepatitis B (OHB), or persistent HBV DNA in patients who are hepatitis B surface antigen (HBsAg) negative, is a recently recognized entity. In an attempt to summarize the issues, this review presents an overview of the current proposed hypothesis on the clinical relevance and also updates the knowledge on the classification of OHB in different clinical settings.Evidence AcquisitionOHB could be found in different population and clinical backgrounds including: viral co-infections (with either human immunodeficiency or hepatitis C viruses), HBV chronic carriers, dialysis patients, transplantation settings and certain clinical situations (named in here: special clinical settings) with no apparent distinguishable clinical parameters.ResultsThe exact magnitude, pathogenesis, and clinical relevance of OHB are unclear. Even the possible role exerted by this cryptic infection on liver disease outcome, and hepatocellular carcinoma development remains unknown.ConclusionsMonitoring of Individuals with positive anti-HBc, mass immunization programs and improvement in diagnostic tools seem to be important to control the probability of transmission of HBV through cryptic HBV infection.

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“…Selim et al reported that in 60 HBsAg-negative patients with chronic HCV infection, HBV DNA was detected in four (13.3%) of 30 patients with normal or slightly high alanine aminotransferase (ALT) levels 31. However, in those with ALT flare ( n = 30), HBV DNA was detected in 19 (63.3%) patients ( P < 0.001) 31. This indicates that in patients with HCV, OBI may contribute to increased plasma HCV RNA loads and liver transaminase levels.…”

Section: Obi and Chronic Hcv Infection: Effect On Progression Of Livementioning

confidence: 99%

Clinical Significance of Occult Hepatitis B Infection in Progression of Liver Disease and Carcinogenesis

Nishikawa¹,

Osaki²

2013

J. Cancer

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Occult hepatitis B infection (OBI) is defined as long-lasting persistence of hepatitis B virus (HBV) DNA in the liver of patients with hepatitis B surface antigen (HBsAg)-negative status, with or without serological markers of previous exposure (antibodies to HBsAg and/or to hepatitis B core antigen). Over the past two decades, significant progress has been made in understanding OBI and its clinical implications. OBI as a cause of chronic liver disease in patients with HBsAg-negative status is becoming an important disease entity. In conditions of immunocompetence, OBI is inoffensive in itself and detection of HBV DNA in the liver does not always indicate active hepatitis. However, when other factors that cause liver damage, such as hepatitis C virus infection, obesity and alcohol abuse are present, the minimal lesions produced by the immunological response to OBI might worsen the clinical course of the underlying liver disease. Several lines of evidence suggest that OBI is associated with progression of liver fibrosis and the development of hepatocellular carcinoma in patients with chronic liver disease. The major interest in OBI is primarily associated with the growing, widely discussed evidence of its clinical impact. The aim of this review is to highlight recent data for OBI, with a major focus on disease progression or carcinogenesis in patients with chronic liver disease.

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Role of occult hepatitis B virus in chronic hepatitis C patients with flare of liver enzymes

Cited by 26 publications

References 35 publications

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

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

Occult Hepatitis B (OBH) in Clinical Settings

Clinical Significance of Occult Hepatitis B Infection in Progression of Liver Disease and Carcinogenesis

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