Background: The OCCULT HEPATITIS B infection (OBI) is defined as the presence of HEPATITIS B virus (HBV) DNA in the sera or in the liver biopsy and the absence of HEPATITIS B surface antigen (HBsAg) by serological test.Objectives: The current study aimed to evaluate the OCCULT HBV infection by polymerase chain reaction (PCR) and determine HBV genotyping among the patients with abnormal alanine transaminase (ALT) in Ahvaz city, Iran.Patients and Methods: The sera of 120 patients, 54 (45%) females and 66 (55%) males, with abnormal ALT 40-152 IU were collected. All the patients were negative for HBsAg for more than one year. The patients sera were tested by PCR using primers specified for the S region of HBV. Then the positive PCR products were sequenced to determine HBV genotyping and phylogenic tree.Results: Of these 120 subjects, 12 (10%) patients including 6 (5%) males and 6 (5%) females were found positive for HBV DNA by PCR, which indicated the presence of OCCULT HBV infection among these patients. The sequencing results revealed that genotype D was predominant with sub-genotyping D1 among OBI patients.Conclusions: OCCULT HEPATITIS B infection is remarkably prevalent in Ahvaz, Iran, and should be considered as a potential risk factor for the transmission of HEPATITIS B Virus throughout the community by the carriers.

Background and objective: OCCULT HEPATITIS B virus (HBV) infection is characterized by presence of HBV infection with undetectable HBsAg. OCCULT HEPATITIS B infection is more common in a number of subgroups, including injection drug users (IDUs) and they are considered as a high risk group for HBV infection.This study aimed to determine the prevalence of OCCULT HBV infection among male IDUs with isolated anti-HBc.Materials and methods: A total of 153 IDUs were included in this study. HBsAg, anti-HBs, anti-HBc, anti-HCV and anti-HIV were tested in all subjects. The presence of HBV-DNA was determined in plasma samples of individuals with isolated anti-HBc by real-time PCR.Results: Of 153 injection drug users enrolled in this study, 11 subjects (7.2%, .95% CI, 3.2%- 11.2%) had isolated anti-HBc.HBV-DNA was detectable in none of 11 patients who had isolated anti-HBc. HBV-HCV co-infection was observed in 5.9%, HBV-HIV co-infection in 2% and HCVHIV co-infection in 5.2% of cases.1.3% of subjects were co-infected with HBV, HIV and HCV.Conclusions: Our survey showed that isolated anti-HBc and OCCULT HBV infection were negligible in injection drug users who living in the Central province of Iran, where HBV prevalence is low, regardless of age, the type of drug (s) consumed, duration of injection drug use and HIV infection.

Background: OCCULT HEPATITIS B virus infection (OBI) is defined as the presence of HEPATITIS B virus (HBV) DNA in the liver and/or in the serum of patients with negative results of HEPATITIS B s antigen (HBsAg) test with or without serological markers of previous viral exposure. The impact of OBI in patients with chronic HEPATITIS C (CHC) is still unclear.Objectives: The Aim of this study was to assess OBI prevalence and its potential implications on treatment outcome in a cohort of patients with CHC underwent standard antiviral therapy.Patients and Methods: Baseline serum samples from 137 HBsAg-negative CHC patients treated with pegylated-interferon and ribavirin (73 Responders/74 Non Responders), were retrospectively analyzed for HBV status.Results: Seventy-three patients (53.3%) showed markers of previous exposure to HBV. HBV DNA was detected in 2 of 137 serum samples (1.5%), both carrying HBV antibodies. Liver biopsies and post-therapy sera were available for 35 patients (12 Responders/23 Non Responders). HBV DNA sequences were found in 13 of 35 specimens (37.1%), all of patients with HBV DNA negativity in basal and post-therapy serum samples. Among OBI-positive patients, 5 (38.5%) carried serological markers of HBV infection. Regarding therapy outcome, in the OBI-positive group there were 5 of 13 (38.5%) sustained virological responders (SVR) compared to 7 of 22 (31.8%) in the OBI-negative one.Conclusions: Despite the high prevalence rate of liver HBV DNA in patients with CHC, SVR was not affected by OCCULT HBV infection.

Background: Detection of HEPATITIS B virus (HBV) genomes without detectable HEPATITIS B surface antigen (HBs-Ag) is termed OCCULT HBV infection (OHBV) that may be transmitted by blood transfusion or organ transplantation and has acute reactivation when an immunosuppressive status like human immunodeficiency virus (HIV) infection occurs. We aimed to evaluate OHBV in HIV-infected patients with isolated antibodies to HEPATITIS B core antigen (anti-HBc) in Isfahan, Iran.Materials and Methods: In a cross-sectional study during August-September 2011, serum samples from HIV-infected patients who attended Isfahan Consultation Center for Behavioral Diseases were tested for HBs-Ag and anti-HBc using ELISA method. HBV-deoxyribonucleic acid (DNA) was detected and quantified in plasma of HBs-Ag negative/anti-HBc positive subjects by real-time polymerase chain reaction.Results: From 64 HIV-positive individuals, 12 (18%) patients were HBs-Ag negative/anti-HBc positive, and from those 3 (25%) had detectable HBV-DNA in their plasma.Conclusion: It seems that OCCULT HBV might be assessed and be treated in HIV-infected patients.

Background: OCCULT HEPATITIS B infected (OBI) patients cannot eradicate HEPATITIS B virus (HBV) -DNA from their liver and peripheral blood, completely.Objectives: The main aim of this study was to investigate the rate of HLA-A2 expression on peripheral blood mononuclear cells (PBMCs) of patients with OBI.Materials and Methods: In this experimental study, intensity of HLA-A2 was measured on the PBMCs of 57 OBI patients and 100 HBsAg-/anti-HBc+/HBV-DNA samples were enrolled as controls; measurements were performed using the flow cytometry technique.Results: Flow cytometric analysis indicated that 19 (33.3%) OBI patients and 28 (28%) controls expressed HLA-A2 antigen on their PBMCs. There was no significant difference between the two groups regarding the rate of individuals expressing HLA-A2 antigen. Statistical analyses showed that the intensity of HLA-A2 expression significantly decreased in OBI patients (3.58±0.1) in comparison to healthy controls (4.21±0.25; P<0.001).Conclusions: According to these results it can be concluded that decreased intensity of HLA-A2 on the PBMCs of OBI patients may lead to resistance of HBV in the patients.

Context: HEPATITIS B virus (HBV) is the most common disease commuted through blood transfusion. OCCULT HEPATITIS B infection (OBI) is a form of the disease which does not present HEPATITIS B surface antigens (HBsAg) in the serum of patients; however, HBVDNA is detectable in the serum and hepatocytes of patients. OBI is an important risk factor to induce post transfusion HEPATITIS (PTH), cirrhosis, hepatocellular carcinoma (HCC) and reactivation of the HBV. Recently, several reports from various regions of the world have been published regarding PTH among blood recipients as well as HCC, and cirrhosis among patients who require permanent blood transfusion, including diseases such as hemophilia, hemodialysis and thalassemia. This form of the HEPATITIS also creates problems for individuals that are co-infected with other viruses such as HCV and HIV. To determine the prevalence of OBI among hemophilia, hemodialysis and thalassemia patients is important because it is a high risk factor for PTH, HCC and cirrhosis therefore, its detection is a critical strategy for most health care services. This review addresses recent information regarding prevalence of OBI in relation to the mentioned diseases.Evidence Acquisition: The data presented here was collected by searching the key words in Pubmed and Scopous databases Results: Our searching in the published papers revealed that OBI prevalence is frequent in patients receiving frequent blood transfusions.Conclusions: it seems that one of the main mechanisms for OBI transmission is most likely through infected blood and its component and evaluation of the prevalence of OBI in donors and patients, especially those with hemophilia and thalassemia should be foul considered.

The prevalence of end-stage renal disease has increased dramatically in developing countries, and this has been accompanied by the widespread utilization of chronic hemodialysis in its management prior to kidney transplantation. Within this group, the interjection of HEPATITIS B virus (HBV) infection represents a significant co-morbidity event that has led to several outbreaks of HEPATITIS B. OCCULT HEPATITIS B (OHB) is a variant of conventional HEPATITIS B that is manifested by the presence of HBV DNA in blood and/or tissue in the absence of HEPATITIS B surface antigen (HBsAg). It is postulated that its impact on chronic hemodialysis patients also might be of importance. Unfortunately, there are only a limited number of published studies on this topic and, in most cases, only prevalence data are reported without descriptions of histopathology or outcome measurements. In this paper, we have reviewed this information. Based on the scarcity of available data, HBV DNA assessment with highly sensitive assays might be informative in this target population, especially among those hemodialysis patients who present with isolated antibodies to the HEPATITIS B core antigen (anti-HBc) or who are HEPATITIS C virus (HCV) RNA positive, since HCV coinfection appears to worsen the outcome. Clearly, more precise studies need to be performed to answer questions concerning the impact of OHB in chronic hemodialysis patients.

Human immunodeficiency virus (HIV)- infected patients are at risk of acquiring viral HEPATITIS, due to common routes of transmission. As the introduction of highly active antiretroviral therapy (HAART) reduced the frequency of opportunistic infections and improved survival, viral HEPATITIS emerged as an important cause of morbidity and mortality in HIV-infected cases. OCCULT HEPATITIS B virus (HBV) infection is characterized by presence of HBV infection without detectable HEPATITIS B surface antigen (HBsAg). There are conflicting reports on the impact of OCCULT HBV infection on the natural history of HIV disease. In this review, we described the findings of studies on HIV and HEPATITIS B co-infection with focus on the prevalence of OCCULT HBV infection. The results of this review demonstrated the importance of prevention, diagnosis and treatment of OCCULT HBV infection in HIV-positive patients.