Occult Hepatitis B Virus Infection among β-Thalassemia Major Patients in Ahvaz City, Iran

Author(s):  
Fatemeh Amirhashchi ◽  
Azarakhsh Azaran ◽  
Seyed Saeid Seyedian ◽  
Shahram Jalilian ◽  
Bijan Keikhaei

Occult Hepatitis B Infection (OBI) is a critical risk factor for triggering post-transfusion hepatitis (PTH), cirrhosis, hepatocellular carcinoma, and hepatitis B virus (HBV) reactivation, which β-thalassemia major (BTM) patients are at risk of it due to multiple blood transfusions. This study was aimed at determining the prevalence of OBI among BTM patients from Khuzestan Province, Iran. In this cross-sectional study, 90 thalassemia patients, who have received blood 36 to 552 times, participated referred to the Shafa hospital of Ahvaz city from January 2018 to April 2019. ELISA for determining serological markers (HBsAg, anti-HBc, anti-HBs, and anti-HCV) and real-time PCR for detecting HBV-DNA were performed; Nested PCR was conducted for DNA sequencing and determining the genotype of OBI case. Phylogenetic and statistical analyses were done by R package. Of 90 subjects enrolled in this study; 95.5% (86/90) were HBsAg negative, and the frequency of OBI among them was 1.16% (1/86). The anti-HBs, anti-HBc, and anti-HCV were detected in 80.00%, 7.78%, and 12.2% of patients, respectively. HBV-DNA was assessed at four HBsAg-positive subjects as well, and all of them were negative. The phylogenetic analysis showed that the detected HBV DNA in the OBI case belongs to the genotype D. This research, for the first time, demonstrated that OBI is present among β-thalassemia patients in Iran. Also, further studies are necessary to determine the actual prevalence of OBI among BTM patients in Iran to decisions concerning OBI screening, especially in transfusion centers.

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Oluyinka Oladele Opaleye ◽  
Adeolu Sunday Oluremi ◽  
Adetona Babatunde Atiba ◽  
Moses Olubusuyi Adewumi ◽  
Olatunji Victor Mabayoje ◽  
...  

HIV has been known to interfere with the natural history of hepatitis B virus (HBV) infection. In this study we investigate the prevalence of occult hepatitis B virus infection (OBI) among HIV-infected individuals in Nigeria. Overall, 1200 archived HIV positive samples were screened for detectable HBsAg using rapid technique, in Ikole Ekiti Specialist Hospital. The HBsAg negative samples were tested for HBsAg, anti-HBc, and anti-HCV by ELISA. Polymerase chain reaction was used for HBV DNA amplification and CD4 counts were analyzed by cytometry. Nine hundred and eighty of the HIV samples were HBsAg negative. HBV DNA was detected in 21/188 (11.2%) of patients without detectable HBsAg. CD4 count for the patients ranged from 2 to 2,140 cells/μL of blood (mean = 490 cells/μL of blood). HCV coinfection was detected only in 3/188 (1.6%) of the HIV-infected patients (P>0.05). Twenty-eight (29.2%) of the 96 HIV samples screened were positive for anti-HBc. Averagely the HBV viral load was <50 copies/mL in the OBI samples examined by quantitative PCR. The prevalence of OBI was significantly high among HIV-infected patients. These findings highlight the significance of nucleic acid testing in HBV diagnosis in HIV patients.


Author(s):  
Rahil Nahid Samiei ◽  
Somayeh Shokri ◽  
Shahab Mahmoudvand ◽  
Manoochehr Makvandi ◽  
Heshmatollah Shahbazian ◽  
...  

Hepatitis B virus is a major public health impasse all over the world. Recently a new form of hepatitis B infection named Occult hepatitis B Infection (OBI) has appeared globally. The OBI is defined as the presence of HBV DNA in the liver and/or blood in the absence of detectable serum HBsAg with/without anti-HBc or anti-HBs. The prevalence of OBI has been reported in hemodialysis (HD) patients in different regions of the world. Thus, this study investigated the prevalence of OBI among HD patients. The cross-sectional study was carried out on 84 HD patients. These sera were checked for HBsAg, HBc-IgG assessment using Enzyme linked immunosorbent assay. The DNA was extracted from the sera samples and tested for HBVDNA detection using Nested Polymerase Chain Reaction (Nested PCR). The liver function tests including serum alanine aminotransferase and aspartate aminotransferase levels were carried out for all the HD individuals. 52/84(61.9%) of HD were males and 32/84 (38.1%) were females. The patient’s age ranged from 25 to 64 with a mean age of 52.4±15.2 years. HBsAg and HBc-IgG were detected in 1(1.1%) female. 2 (2.4%; a female and a male) patients were positive for HBsAg. 14/84 (16.7%; 6 female and 8 male) HD patients were positive for anti-HBc but negative for HBsAg, among them 4(28.6%; 2 female and 2 male) cases were positive for HBV DNA, indicating the presence of OBI in HD patients. Even distribution of OBI among the HD was found in 2(2.36%) male and 2(2.36%) female (P>.0.05). In the present study the moderate rate of 4.76% OBI has been observed in HD patients. The prevalence of seropositive OBI among the gender was 2(2.36%) male and 2(2.36%) female. The seronegative OBI have not been detected in the present study but requires further investigation. In this study the affliction of OBI in HD patients is not clear.


Author(s):  
Mashaer M Mustafa ◽  
Abdel Rahim M El Hussein ◽  
Isam M Elkhidir ◽  
Khalid A Enan

This study was carried out to detect occult hepatitis B virus (OHB) among renal transplant patients in Khartoum State, Sudan. Antigen capture enzyme linked immunosorbent assay (ELISA) competitive ELISA and polymerase chain reaction (PCR) were used to respectively detect hepatitis B surface antigen (HBsAg), ; Hepatitis B core antibody (HBcAb) and hepatitis B virus (HBV) DNA in 100 plasma samples collected from patients during the period from May to October 2018 . Out of the 100 patients sampled, 70 were males and 30 were females (age 15 to 65 years) and none of these patients showed signs of clinical hepatitis. The results showed that 3 out of the 100 samples were positive for HBsAg, and were subsequently excluded from the study. Out of the remaining HBsAg negative 97 samples, 39(40.2%) showed positive HBcAb and none (0%) tested positive to HBV DNA using competitive ELISA and PCR, respectively. These results indicated that more investigations including more patients from other transplant centers are needed to fully elucidate the situation of occult hepatitis B in renal transplant patients in Sudan.


2021 ◽  
Author(s):  
Paniz Shirmast ◽  
Mahdi Abedinzade Shahri ◽  
Salar Pashangzadeh ◽  
Hessam Mirshahabi ◽  
Elham Samadi ◽  
...  

Aim: Occult hepatitis B infection (OBI) is life threatening and has a high mortality rate despite applying antiviral treatments in cancer patients. This study aimed to investigate the prevalence of OBI in patients undergoing chemotherapy in Iran. Materials & methods: A total of 342 patients undergoing chemotherapy were enrolled. OBI detection in anti-HBc positive individuals was conducted using nested-PCR. Results: Among 342 subjects, 103 (30.1%) were positive for anti-HBc. Fifteen (14.6%) cases of 103 anti-HBc positive samples were also positive for HBsAg. Overall, HBV DNA was positive in three (3.4%) of 88 anti-HBc subjects. Conclusion: Our results indicated that OBI might occur in almost one in 25 anti-HBc-positive patients undergoing chemotherapy.


Author(s):  
Rana Tabar Asad Laleh ◽  
Zohreh Sharifi ◽  
Akbar Pourfathollah ◽  
Shahram Samei

Background and Aims: Occult hepatitis B virus infection (OBI) is known as an important source of hepatitis B virus (HBV) infection. It is categorized as Hepatitis B surface antigen (HBsAg) not being present and low DNA viral load in serum. In this study, an attempt was made to investigate the outbreak of anti-HBc and OBI among the HBsAg-negative donors in Golestan province. Materials and Methods: The present cross-sectional experiment was conducted on 3500 voluntary blood donors in Golestan province to examine the presence of human immunodeficiency viruses Ag-Ab, HBsAg, and hepatitis C virus Ab. Then, samples with negative results for the mentioned tests were screened for total HBc antibody (IgM-IgG) through ELISA technique. Afterward, HBV-DNA extraction and R-T PCR assay were conducted for all HBsAg negative samples by using Real ART HBV LC PCR kit on a Light Cycler instrument. Results: The study participants included 3255 (93%) male and 245 (7%) female. In general, 385 (11%) out of 3500 samples were anti-HBc positive. HBV-DNA results for every sample with either positive or negative anti-HBc were found to be negative. Conclusions: As the area under study has a high rate of anti-HBc outbreak (11%) without the presence of HBV-DNA, anti-HBc screening can cause blood donor deferrals and limit blood supply; therefore, the HBsAg test with high analytical sensitivity is recommended for HBV screening in this area. Regarding the cost analyses and also the status of HBV endemicity, HBsAg test along with ID-NAT is preferable, if possible, for improving blood safety.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Farhad Shahram ◽  
Saied Ghorbani ◽  
Mahdi Mahmoudi ◽  
Maassoumeh Akhlaghi ◽  
Zohreh Jadali ◽  
...  

Background: Behcet's disease (BD) is a chronic multisystem vasculitis with an unknown etiology. During the past years, several reports are published on the occult hepatitis B infection (OBI), the presence of hepatitis B virus (HBV) DNA in the absence of HBsAg, in rheumatic diseases. Objectives: The current study aimed to, firstly, investigate the prevalence of OBI in patients with BD, and, secondly, its potential association with the clinical and therapeutic status of BD. Methods: HBV serological markers and HBV DNA were evaluated in 220 consecutive BD patients to detect OBI. Demographic and clinical data of OBI positive and negative groups were compared. Results: The mean age of patients was 39.24 (± 10.57), and 134 (62.9%) were male. The mean disease duration was 14.13 (± 8.63) years. No HBsAg positive case was found, but HBV DNA was found in 19 (8.6%) patients. The median viral load value was 475.84 copy/mL. We compared clinical data of 10 OBI positive and 156 OBI negative BD patients with complete and accessible data. There was no difference between the two groups concerning demographic characteristics (age, sex, and disease duration), different clinical manifestations, or types of medications (immunomodulatory, cytotoxic, and corticosteroids). Conclusions: This is the first study showing a rather high prevalence of OBI among BD patients. We did not find any correlation between OBI positivity and different clinical manifestations, medications, or HLA-B51. Further studies are needed on a larger group of patients and by molecular HBV evaluation (as well as serologic) regarding this possible association.


2018 ◽  
Vol 60 (1) ◽  
pp. 57-61
Author(s):  
Rasha N. Hassan ◽  
Ali H. Hussain

Background: Occult Hepatitis B virus infection (OBI) among blood donors is an important medical concern.Objectives: This study was done to detect the presence of occult hepatitis B virus infections among blood donors with negative hepatitis B surface antigen and positive total anti-hepatitis B core antibodies in Hawler Major Blood Bank in Hawler city/Kurdistan Region of Iraq.Methods: A total number of 12,185 blood donors in Hawler Major Blood Bank were screened for HBsAg and total anti-HBcAb using ELISA technique, and then positive results were retested by confirmatory technique by Chemiluminescence assay. All HBsAg-/HBcAb+ were selected as the study group; HBV DNA was tested among HBsAg-/HBcAb+ by conventional PCR and Real time-PCR. Clinical and demographic data of study group were recorded.Results: Among the 12,185 blood donors, HBsAg was positive in 27 (0.22%) donors using Chemiluminescence assay, the frequency of HBs Ag -/ HBc Ab+ was 276 (2.27%), and then the total prevalence of HBV infection in all blood donors was 2.49%. Among the 276 HBs Ag-/HBcAb+, occult hepatitis B virus infection (OBI) was positive in 39.1% (108/276) using conventional PCR and Real time-PCR techniques, while the prevalence among all blood donors (n=12,185) was 0.09%. Testing of HBV-DNA in HBs Ag -/ HBc Ab+ group for OBI was done by qualitative PCR (positive HBV-DNA=102/276) or by quantitative Real time-PCR (positive HBV-DNA=108/276).Conclusions: The OBI is frequently detected among blood donors in Hawler city especially those have HBsAg-/HBcAb+, and the total anti-HBcAb is an essential serological marker for screening HBV among blood donors. The risk factors for developing OBI among blood donors should be elucidated.   الحامض النووي  الريبوزي منقوص الأكسجين للفايروس الكبدي نوع ب في دم المتبرعين والموجب لأضداد اللب للفايروس وسالب للستضد السطحي للفايروس في مصرف الدم الرئيسي في اربيل/كردستان العراق  رشا نزار حسن علي حاتم حسين نظرة اولية: ان تواجد الاصابة  بالفايروس الكبدي نوع ب لدى المتبرعين بالدم يعتبر من الحالات الطبية التي يجب الانتباه اليها. الاهداف: تم اجراء هذه الدراسة على المتبرعين بالدم في مصرف الدم الرئيسي في مدينة اربيل/كردستان العراق , لغرض التحري عن وجود الاصابات الكبدية الفايروسية نوع ب المخفية لدى المتبرعين بالدم والذين يكون المستضاد السطحي الفايروسي الكبدي نوع ب (HBsAg) سالبا لديهم ويكون المضاد اللبي الكلي لنفس الفايروس(anti-HBcAb) موجبا. طريقة البحث: تم فحص اثنا عشر الفا ومائه وخمس وثمانين متبرع بالدم في مصرف الدم الرئيسي في مدينة اربيل لغرض الكشف عن (HBsAg) و  (anti-HBcAb) وان النتائج الموجبة تم اعادة فحصها بطرق فحص تأكيدية. ان كل المتبرعين ذوو النتائج (السالبة HBsAg ) / و (الموجبة anti-HBcAb) تم انتقئهم كمجموعة الدراسة وتم فحص وجود الحامض النووي  الريبوزي منقوص الأكسجين للفايروس الكبدي نوع ب لديهم في الدم بطريقتين: طريقة تفاعل البوليميراز المتسلسل التقليدية وطريقة تفاعل البوليميراز المتسلسل اللحظي. كما تم تسجيل البيانات الديموغرافية والسريرية لمجموعة الدراسة. النتائج:  لدى فحص المتبرعين البالغ عددهم  اثنا عشر الفا ومائه وخمس وثمانين متبرع تبين وجود سبعة وعشرون اصابة (0.02%)  بالمستضاد (HBsAg) اما عدد المتبرعين الذين ليس لديهم  / HBsAg والموجبة للمضاد anti-HBcAb  فقد كان 276 (2.27%) وقد تبين ان نسبة انتشار الخمج البدي الفايروسي نوع ب لدى المتبرعين كان 2.49%. عند فحص مجموعة الدراسة البالغ عددها 276 والذين كانت نتيجة فحصهم موجبة للمضاد /HBcAb,وسالبة للمستضاد HBsAg ,تبين وجود الخمج الفايروسي الكبدي نوع ب المخفي في 39.1% (108/276),  بينما كانت نسبة انتشار نفس الخمج لدى مجموع المتبرعين الكلي البالغ 12185 هو 0.09%. لقد كانت نتيجة فحص وجود الحامض النووي  الريبوزي منقوص الأكسجين للفايروس الكبدي نوع ب بالطريقة القليدية هي 102 متبرع من مجموعة الدراسة الباغة 276 اما النتيجة لنفس مجموعة الدراسة لنفس الحامض النووي بطريقة تفاعل البوليميراز المتسلسل اللحظي كانت 108. الاستنتاج: لقد بينت هذه الدراسة وجود وجود الخمج الفايروسي الكبدي نوع ب المخفي بصورة متكررة لدى المتبرعين بالدم في مدينة اربيل وخاصة الذين تكون حالتهم  موجبة للمضاد /HBcAb, وسالبة للمستضاد HBsAg كما بينت الدراسة ان فحص  المضاد اللبي للفايروس الكبدي نوع ب هو ضروري عند التحري عن وجود وجود الخمج الفايروسي الكبدي نوع ب لدى المتبرعين بالدم, كما انه من الضروري التقصي عن عوامل الخطورة التي تؤدي الى الاصابة بالخمج الفايروسي الكبدي نوع ب المخفي. الكلمات المفتاحية: المتبرعون بالدم, الخمج الفايروسي الكبدي نوع ب المخفي, مدينة اربيل, مصرف الدم, تفاعل البوليمراز المتسلسل التقليدي واللحظي


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244947
Author(s):  
Adil Salyani ◽  
Jasmit Shah ◽  
Rodney Adam ◽  
George Otieno ◽  
Evelyn Mbugua ◽  
...  

Background Occult hepatitis B virus (HBV) infection (OBI) is a phase of HBV infection characterised by the presence of HBV DNA in the absence of detectable hepatitis B surface antigen (HBsAg). OBI is of concern in the HIV-infected due to high prevalence and risk of HBV reactivation. The prevalence and clinico-demographic characteristics of OBI in anti-retroviral therapy (ART) naïve HIV infected adults in Kenya is unknown. Methods A cross sectional study carried was out at three sites in Kenya. HIV infected ART naïve adults were enrolled and demographic data collected. Blood samples were assayed for HBsAg, HBV DNA, alanine aminotransferase, aspartate aminotransferase, antibodies to hepatitis B surface antigen (anti-HBs) and hepatitis B core antigen (anti-HBc). Data on CD4 count, HIV viral load and platelet count were obtained from medical records. Results Of 208 patients, 199 (95.7%) did not report HBV vaccination, 196 (94.2%) were HBsAg negative, 119 (57.2%) had no HBV markers, 58 (27.9%) had previous HBV infection (anti-HBc positive) and 11 (5.3%) had OBI. All 11 (100%) OBI patients were anti-HBc positive. OBI patients comprised 19.0% of HBsAg negative, anti-HBc positive patients. There was no difference in clinico-demographic characteristics between the overt HBV, OBI and HBV negative patients. Conclusion This was the first study on OBI in ART naïve HIV infected adults in Kenya. The lower OBI prevalence compared to other sub-Saharan African countries could be attributed to lower HBV exposure. Most patients were HBV unexposed and unimmunized, outlining the need to implement guideline recommended immunization strategies.


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