Occult Hepatitis (B) Virus Infection among Patients Who Have Received Direct-Acting Antiviral Drugs for Hepatitis (C) Virus infection

Abstract

Occult HBV infection (OBI) is defined as detecting HBV DNA (in
blood and/or liver tissue) without detectable HBsAg with or without anti-HBc or antiHBs. The clinical importance of occult HBV infection may be noticed in the
following clinical contexts: transmission of HBV infection after blood transfusion
and organ transplantation, reactivation of chronic hepatitis B with exposure to
immunosuppression, and implication in chronic liver diseases (CLD), especially with
cryptogenic chronic liver diseases, HCV-related chronic liver diseases, and
hepatocellular carcinoma.
Aim of the Study: To determine the prevalence of occult HBV infection in HCV
related chronic liver disease and to investigate the possible role of occult HBV
infection in patients who have received Direct Acting Antivirals (DAAs) for HCV
related chronic liver disease by clarifying the clinical and laboratory features of occult
HBV infection in HCV related chronic liver disease.
Patients and Methods: The present study was conducted in the gastroenterological
Department, Cairo Fatemic Hospital. This study included 198 patients who have
received treatment for the hepatitis C virus. All patients were subjected to the
following: thorough history taking, careful clinical examination, abdominal
ultrasonography, complete blood picture, liver function tests (total and direct
bilirubin, total plasma proteins and albumin, and liver enzymes, and coagulation tests
Results: We found that occult HBV correlated with the clinical picture, laboratory
investigations for all the studied patients.
Conclusion: Occult hepatitis B was detected in a significant number of patients using
HBc IgG so check HBc IG status before initiating pan-oral DAAs therapy is
important, as occult HBV may contribute to chronic liver damage, development of
HCC and flare of liver enzyme and role of OBI on the outcome of DAAs treatment
for HC OBI is a life-threatening public health problem worldwide.