Detection of occult HBV infection by nested PCR assay among chronic hepatitis C patients with and without hepatocellular carcinoma

Occult hepatitis B virus infection [OBI] has been reported among patients with chronic hepatitis C virus [HCV] infection and hepatocellular carcinoma [HCC]. This study aimed to evaluate the prevalence of OBI in chronic hepatitis C patients with and without hepatocellular carcinoma. A total of 40 chronic hepatitis C patients who were negative for HBsAg, were enrolled into the study. They were classified into two groups: Group I which included 20 patients with chronic hepatitis C only whereas Group II included 20 patients with chronic hepatitis C and HCC. Detection of HBV DNA was done by nested-PCR using two sets of primers specific for surface and X viral genomes in serum and liver tissue of patients. Genotyping system based on PCR using type-specific primers was done for HBV-DNA positive intrahepatic samples. OBI was detected in the liver tissue in 23/40 [57.5%] of chronic HCV infected patients, 18 [78.3%] of whom belonged to group II, conferring a 90% prevalence of this group. In serum, HBV-DNA was detected in 9/40 patients [22.5%], 7 [77.8%] of whom belonged to group II. Among the 23 positive intrahepatic HBV-DNA samples studied, HBV-genotype D [34.8%] and B [26.1%] were more predominant, whereas HBV-genotype C [13.1%] and A [8.7%] infections were the least observed, respectively; mixed genotypes were detected in 17.4% [n = 4], 3 of them were with HBV-genotype D and B, and 1 was with HBV-genotype C and A. In conclusion OBI is a fact in our community; it was detected in liver tissue of chronic HCV-infected patients, especially in cases of chronic HCC. In addition, OBI might be related to severity of necroinflammatory activity and fibrosis. Large studies are needed to confirm that co-infection could determine a worse progress of chronic liver disease in this population. Also, detection of intrahepatic HBV-DNA is more useful in diagnosis of OBI