Prevalence of occult hepatitis B infection in patients with cryptogenic cirrhosis

Year 2019, Volume: 44 Issue: 3, 753 - 757, 30.09.2019

Serkan Yalaki , Mehmet Suat Yalçın

https://doi.org/10.17826/cumj.419941

Abstract

Purpose: The frequency of occult hepatitis B is variable in patients with cryptogenic cirrhosis and is unknown in our region. The presence of HBV DNA in serum of cirrhotic patients can be determined by molecular techniques despite the lack HBV serological markers. We aimed to determine the frequency of occult hepatitis B virus in patients with cryptogenic cirrhosis in this study.

Materials and Methods: This cross-sectional study was designed to assess the prevalence of occult HBV infection in a group of patients with cryptogenic liver cirrhosis. Forty-four patients with cryptogenic cirrhosis who were examined in our hospital were enrolled in this study. Their serum were studied for HBV DNA levels using a real-time PCR method.

Results: There were 44 patients in the study group; Positive for anti-hepatitis B surface antibody was detected in 22 patients, and positive for hepatitis B core antibody was detected in 24 patients. In 2 patients, HBV DNA was found to be positive. In our study, occult HBV infection was found in 4.5% (2/44) of patients with cryptogenic cirrhosis.

Conclusion: The prevalence of occult HBV infection was relatively high in patients with cryptogenic cirrhosis; Occult hepatitis B infection may thus play a role in the development of decompensated cirrhosis and complications in cases of cryptogenic liver disease. 

Keywords

Occult hepatitis B, Cryptogenic cirrhosis, PCR, HBV DNA

Kriptojenik sirozlu hastalarda okült hepatit B sıklığı

Abstract

Amaç: Kriptojenik sirozlu hastalarda okült hepatit B sıklığı değişkendir ve bölgemizde sıklığı bilinmemektedir. HBV serolojik belirteçleri olmamasına ragmen HBV DNA'sının bu sirotik hastalardaki varlığı moleküler tekniklerle belirlenebilir. Bu çalışmada kriptojenik sirozlu hastalarda okült hepatit B varlığının sıklığını belirlemeyi amaçladık.

Gereç ve Yöntem: Bu kesitsel çalışma, kriptojenik karaciğer sirozu olan bir grup hastada okült HBV enfeksiyonunun yaygınlığını değerlendirmek için tasarlanmıştır. Bu çalışmada kliniğimizce takip edilen kriptojenik sirozlu 44 hasta çalışmaya alındı. Bu hastaların serumları gerçek zamanlı bir PCR yöntemi kullanılarak, HBV DNA seviyeleri için incelenmiştir.

Bulgular: Çalışma grubunda 44 hasta vardı; 22 hastada anti-HBs antikoru pozitif saptandı, 24 hastada anti-HBc pozitif bulundu; 2 hastada HBV DNA pozitif bulundu. Bizim çalışmamızda kriptojenik sirozlu hastaların %4,5'inde (2/44) gizli HBV enfeksiyonu saptandı.

Sonuç: Kriptojenik sirozlu hastalarda okült HBV infeksiyonu prevalansı nispeten yüksek saptandı. Okült hepatit b enfeksiyonu kriptojenik karaciğer hastalığı vakalarında dekompanse siroz ve siroza bağlı komplikasyonların gelişmesinde rol oynuyor olabilir.

Keywords

Okült hepatit B, HBV DNA, PCR, Kriptolenik siroz

References

• 1. Lavanchy D. Chronic viral hepatitis as a public health issue in the world. Best Pract Res Clin Gastroenterol 2008; 22: 991-1008. DOI:10.1016/j.bpg.2008.11.002.
• 2. Lok AS, McMahon BJ. Chronic hepatitis B. Hepatology 2001; 34: 1225-1241. DOI:10.1053/jhep.2001.29401
• 3. Lok AS. Chronic hepatitis B. N Engl J Med 2002; 346: 1682 DOI:10.1056/NEJM200205303462202
• 4. Akhan S, Aynıoğlu A, Çağatay A, et al. Management of chronic hepatitis B virus infection: a Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases. Klimik Derg 2014; 27(Suppl. 1): 2-18. DOI:10.5152/kd.2014.26
• 5. Brechot C, Thiers V, Kremsdorf D, et al. Persistent hepatitis B virus infection in subjects without hepatitis B surface antigen: clinically significant or purely ‘occult’? Hepatology 2001; 34: 194-203. DOI:10.1053/jhep.2001.25172
• 6. Hu KQ. Occult hepatitis B virus infection and its clinical implications. J Viral Hep 2002; 9: 243-257. DOI:10.1046/j.1365-2893. 2002. 00344.x
• 7. Kwak MS, Kim YJ. Occult hepatitis B virus infection. World J Hepatol 2014; 6: 860-869. DOI:10.4254/wjhv6.i12.860
• 8. Raimondo G, Pollicino T, Cacciola I, Squadrito G. Occult hepatitis B virus infection. J Hepatol 2007; 46: 160-170. DOI:10.1016/j.jhep.2006.10.007
• 9. Rodriguez-Inigo E, Bartolome J, Ortiz-Movilla N, et al. Hepatitis C virus (HCV) and hepatitis B virus (HBV) can coinfect the same hepatocyte in the liver of patients with chronic HCV and occult HBV infection. J Virol 2005; 79: 15578-15581. DOI:10.1128/JVI.79.24.15578-15581.2005
• 10. Chemin I, Zoulim F, Merle P, et al. High incidence of hepatitis B infections among chronic hepatitis cases of unknown aetiology. J Hepatology 2001; 34: 447-454. DOI:10.1016/s0168-8278(00)00100-8
• 11. Minuk GY, Sun DF, Greenberg R, et al. Occult hepatitis B virus infection in a North American adult hemodialysis patient population. Hepatology 2004; 40: 1072-1077. DOI:10.1002/hep.20435
• 12. Tramuto F, Maida CM, Colomba GM, Di Carlo P, Vitale F. Prevalence of occult hepatitis B virus infection in a cohort of HIV-positive patients resident in Sicily, Italy. Biomed Res Int 2013: 859583. DOI:10.1155/2013/859583
• 13. Nishikawa H, Osaki Y. Clinical significance of occult hepatitis B infection in progression of liver disease and carcinogenesis. J Cancer 2013; 4: 473-480. DOI:10.7150/jca.6609
• 14. Kitab B, Ezzikouri S, Alaoui R, et al. Occult HBV infection in Morocco: from chronic hepatitis to hepatocellular carcinoma. Liver Int 2014; 34: e144-e150. DOI:10.1111/liv.12482
• 15. Lledo JL. Diagnostic strategy for occult hepatitis B virus infection. World J Gastroenterol 2011; 17: 1553-1557. DOI:10.3748/wjg.v17.i12.1553
• 16. Berasain C, Betes M, Panizo A, et al. Pathological and virological findings in patients with persistent hypertransaminasaemia of unknown aetiology. Gut 2000; 47: 429-35. DOI:10.1136/gut.47.3.429
• 17. Honarkar Z, Alavian SM, Samiee S, Saeedfar K, Zali MR. Occult hepatitis B among chronic liver disease patients. Saudi Med J 2005; 26: 601-606.
• 18. Kaviani MJ, Behbahani B, Mosallaii MJ, Sari-Aslani F, Taghavi SA. Occult hepatitis B virus infection and cryptogenic chronic hepatitis in an area with intermediate prevalence of HBV infection. World J Gastroenterol. 2006; 12: 5048-5050. DOI:10.3748/wjg.v12.i31.5048
• 19. Hashemi SJ, Hajiani E, Masjedizadeh A, et al. Research Article occult hepatitis b infection in patients with cryptogenic liver cirrhosis in southwest of Iran Jundishapur. J Microbiol. 2015; 8: e16873. DOI:10.5812/jjm.16873
• 20. Heringlake S, Schutte A, Flemming P, Schmiegel W, Manns MP, Tillmann HL. Presumed cryptogenic liver disease in Germany: High prevalence of autoantibody-negative autoimmune hepatitis, low prevalence of NASH, no evidence for occult viral etiology. Z Gastroenterol 2009; 47: 417-423. DOI:10.1055/s-0028-1109146
• 21. Fang Y, Shang QL, Liu JY, et al. Prevalence of occult hepatitis B virus infection among hepatopathy patients and healthy people in China. J Infect 2009; 58: 383-388. DOI:10.1016/j.jinf.2009.02.013
• 22. Song EY, Yun YM, Park MH, Seo DH. Prevalence of occult hepatitis B virus infection in a general adult population in Korea. Intervi- rology. 2009; 52: 57-62 DOI:10.1159/000214633
• 23. Chemin I, Trepo C. Clinical impact of occult HBV infections. J Clin Virol 2005; 34: 15-21. DOI: http://sci-hub.cc/10.1016/S1386-6532(05)80005-8
• 24. Chaudhuri V, Nanu A, Panda SK, Chand P. Evaluation of serologic screening of blood donors in India reveals a lack of correlation between anti-HBc titer and PCR-amplified HBV DNA. Transfusion 2003; 43: 1442-8. DOI:10.1046/j.1537- 2995.2003.00512.x.
• 25. Kasapoğlu B, Türkay C. Okült (OCCULT) hepatit B enfeksiyonu [Occult hepatitis B infection]. Güncel Gastroenetroloji 2007; 11: 51-56. DOI:10.4328/JCAM.1229
• 26. Alhababi F, Sallam TA, Tong CY. The significance of ‘anti-HBc only’ in the clinical virology laboratory. J Clin Virol 2003; 27: 162-169. DOI: http://dx.doi.org/10.1016/S1386-6532(02)00171-3
• 27. Noborg U, Gusdal A, Horal P, et al. Levels of viraemia in subjects with serological marker sofpast or chronic hepatitis B virus infection. Scand J Infect Dis 2000; 32: 249-252. DOI: http://sci-hub.cc/10.1080/00365540050165866
• 28. Tozun N, Özdoğan O, Çakaloğlu Y, et al. Seroprevalence of hepatitis B and C virus infections and risk factors in Turkey: a fieldwork TURHEP study. Clin Microbiol Infect 2015 Nov;21(11):1020-6. DOI:10.1016/j.cmi.2015.06.028.
• 29. Hui CK, Sun H, Au WY, et al. Occult hepatitis b virus infection in hematopoietic stem cell donors in a hepatitis B virus endemic area. J Hepatol 2005; 42: 813-819. DOI:10.1016/j.jhep.2005.01.018
• 30. Beşışık F, Karaca C, Akyüz F, et al. Occult HBV infection and YMDD variants in hemodialysis patients with chronic HCV infection. J Hepato 2003; 38: 506-510. DOI:10.1016/S0168-8278(02)00457-9.
• 31. Kanbay M, Gur G, Akcay A, Selcuk H, Yilmaz U, Arslan H. Is hepatitis C virus positivity a contributing factor to occult hepatitis B virus infection in hemodialysis patients? Dig Dis Sci 2006; 51: 1962-1926. DOI:10.1007/s10620-006-9421-9.
• 32. Altındiş M. Hepatit B virüs (HBV) serolojik belirleyicileri ile HBV DNA’nın varlığının karşılaştırılması [Comparison of hepatitis B virus (HBV) serological markers and existence of HBV DNA]. İnfek Derg 2002; 16: 141-145.
• 33. Hüsnü Altunay, Erdogan Kosan, Ilhan Birinci, et al. Are isolated anti-HBc blood donors in high risk group? The detection of HBV DNA in isolated anti-HBc cases with nucleic acid amplification test (NAT) based on transcription-mediated amplification (TMA) and HBV discrimination. Transfusion and Apheresis Science 2010; 43: 265-268. DOI:10.1016/j.transci.2010.09.012
• 34. Goral V, Ozkul H, Tekes S, Sit D, Kadiroglu AK. Prevalence of occult HBV infection in haemodialysis patients with chronic HCV. World J Gastroenterol 2006; 12: 3420-3424. DOI:10.3748/wjg.v12.i21.3420