Value of PCR in the detection of occult hepatitis B virus infection in chronic end stage liver disease

ABSTRACT

Persistence of Hepatitis B virus [HBV] DNA in HBV surface antigen [HBsAg] negative individuals is termed occult HBV infection. Occult HBV infection has frequently been identified in patients with chronic HCV infection. This study aimed to evaluate the prevalence of occult HBV infection among late stage liver diseased patients and apparently healthy household contacts who may be used as potential donors for their liver transplantation. Also, prevalence of occult l-TBV infection in HCV-Ab and HBcAb seropositive subjects was evaluated. The study included 500 individuals distributed as 100 patients from National Liver Institute, 300 household contacts, and 100 apparently healthy subjects as a control group. All studied individuals were subjected to full history taking, complete clinical examination, abdominal ultrasonography, liver biopsy if possible and laboratory investigations including liver function tests, anti- HCV and HBV serological markers, as well as HBV- DNA detection using nested PCR. HBV-DNA was detected in 54% of patients, 18% of household contacts and 6% of control group. The prevalence of occult HBV infection in HBcAb seropositive subjects was; 75% in patients, 31.6% in household contacts, 46.2% in control group. The prevalence of occult HBV infection in HCV-Ab seropositive subjects was 55.8% in patients, 8.2% in contacts and 10% in control group. In conclusion, there is a high prevalence of occult HBV infection in patients with end stage liver disease, particularly those who are HCV-Ab and or HBcAb seropositive. The results of the current study indicate the need for a sensitive investigation for potentially infected relatives among family members of HBsAg carriers. On the other hand, apparently recovered people, are considered to be at risk for disease complications or for transmission of the infection till proved HBV-DNA negative