Occult hepatitis B virus infection in patients with hepatitis C virus related liver diseases

Background: the persistence of hepatitis B virus [HBV] DNA in liver tissue or serum in the absence of detectable hepatitis B surface antigen [HBsAg] is called occult hepatitis B infection [OBJ]. Both HBV and hepatitis C virus [HCV] are transmitted parenterally, and coinfection is not uncommon, particularly in countries with a high prevalence of one or both viruses

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Aim: this study was conducted to assess OBI prevalence in Egyptian patients with HCV related liver diseases, see if anti-HBc alone can. consider a good marker for detection of OBI, to record the serological profile of occult HB V infected patients, and to detect the clinical impact of this coinfection

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Methods: after exclusion of HBsAg positive patients, serum samples from 128 Egyptian patients with HCV related liver diseases were included in our study. All the patients were positive for anti-HCV and HCV RNA, and negative for HBsAg. Serum samples were collected and subjected to fiver function tests and virological assays for HBsAg, Results: occult HBV infection was detected in 21% of our patients with the highest prevalence found in patients with hepatocellular carcinoma [HCC] [44.4%] followed by patients with cirrhosis [22.2%] then chronic hepatitis C patients [16.3%]. Occult HBV infection can be found in both patients who show previous hepatitis B infection, [22%], and in those who were negative for anti-HBc, [19%]. Occult HBV infection was detected with the highest prevalence in patients with anti-HBc only [51.8%], followed by patients with negative all serological markers [29.6%], then [11.1%] were anti-HBc and anti-HBs, and finally [7.4%] were anti-HBc and anti. HBe. Patients co-infected with occult hepatitis B had significantly a higher prevalence of sever fibrosis [12/27 OBJ versus 13/101 HCV only infected patient, P<0.01] and significantly higher prevalence of decompensated liver disease [3/4 OBJ versus 3/14 HCV only infected patient, P<0.05]

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Conclusion: OBJ is highly prevalent in Egypt. It is frequently associated with HCV-related chronic liver diseases and it may play a major role as an etiological agent for hepatocellular carcinoma in these patients. Occult HBV infection may have a clinical significance as it may increase the liver fibrosis and worsen the liver disease in HCV patients but we think that it doesn't affect the HCV response to combination therapy