Occult hepatitis B virus infection in the setting of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co‐infection: Clinically relevant or a diagnostic problem?

The clinical relevance of occult hepatitis B virus (HBV) infection, defined as detectable HBV DNA serum/liver, in the absence of hepatitis B surface antigen (HBsAg), is unclear. We determined the prevalence of serum occult HBV infection in HIV/HCV co‐infected patients enrolled in APRICOT, a randomized multinational trial that investigated the efficacy and safety of peginterferon alfa‐2a (40 kDa) plus ribavirin for treatment of HCV. We also examined the effect of prior HBV exposure to liver histology at baseline. Only HBsAg‐negative patients were eligible. At screening, serum HBV DNA was assessed by commercial assay (detection limit = 200 copies/mL). Patients were divided into four serological groups: anti‐HBs+/anti‐HBc+; anti‐HBs−/anti‐HBc+; anti‐HBs+/ anti‐HBc−; anti‐HBs−/anti‐HBc−. Baseline liver biopsy grade and stage were compared among groups. Serum HBV DNA was undetectable in all patients, (n = 866). Results of anti‐HBs and anti‐HBc was available for 176 patients: 60 (34.1%) anti‐HBs+/anti‐HBc+; 60 (34.1%) anti‐HBs−/anti‐HBc+; 11 (6.3%) anti‐HBs+/anti‐HBc−; 45 (25.6%) anti‐HBs−/anti‐HBc−. There were no differences among the groups in the histological grade or stage at baseline liver biopsies. Occult HBV infection in serum was not detected in this large immunocompetent cohort. Moreover, prior exposure to HBV did not appear to have any affect on baseline liver histology. J. Med. Virol. 79: 694–700, 2007. © 2007 Wiley‐Liss, Inc.

[1]  G. Raimondo,et al.  Occult hepatitis B virus infection. , 2007, Journal of hepatology.

[2]  E. Sagnelli,et al.  Impact of occult hepatitis B virus infection in HIV patients naive for antiretroviral therapy , 2006, AIDS.

[3]  A. Hartmann,et al.  Serological pattern "anti-HBc alone": characterization of 552 individuals and clinical significance. , 2006, World journal of gastroenterology.

[4]  J. Luk,et al.  Fibrosis progression in chronic hepatitis C patients with occult hepatitis B co-infection. , 2006, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[5]  R. Burnett,et al.  High risk of occult hepatitis B virus infection in HIV-positive patients from South Africa. , 2006, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[6]  F. Wit,et al.  Occult hepatitis B virus infection before and 1 year after start of HAART in HIV type 1-positive patients. , 2005, AIDS research and human retroviruses.

[7]  S. Moreno,et al.  Reactivation of hepatitis B in an HIV-infected patient with antibodies against hepatitis B core antigen as the only serological marker , 2005, European Journal of Clinical Microbiology and Infectious Diseases.

[8]  F. Zoulim,et al.  Analysis of HCV co-infection with occult hepatitis B virus in patients undergoing IFN therapy. , 2005, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[9]  D. Neau,et al.  Occult hepatitis B virus infection in HIV-infected patients with isolated antibodies to hepatitis B core antigen: Aquitaine cohort, 2002-2003. , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[10]  Y. N. Park,et al.  Long-term clinical and histological outcomes in patients with spontaneous hepatitis B surface antigen seroclearance. , 2005, Journal of hepatology.

[11]  M. Opravil,et al.  Frequent chronic hepatitis B virus infection in HIV-infected patients positive for antibody to hepatitis B core antigen only , 2005, European Journal of Clinical Microbiology and Infectious Diseases.

[12]  F. Sugauchi,et al.  Lack of association between occult hepatitis B virus DNA viral load and aminotransferase levels in patients with hepatitis C virus‐related chronic liver disease , 2004, Journal of gastroenterology and hepatology.

[13]  J. Carton,et al.  Isolated presence of antibody to hepatitis B core antigen in patients coinfected with HIV. , 2004, Journal of acquired immune deficiency syndromes.

[14]  J. Montaner,et al.  Peginterferon Alfa-2a plus ribavirin for chronic hepatitis C virus infection in HIV-infected patients. , 2004, The New England journal of medicine.

[15]  E. Rigopoulou,et al.  Occult hepatitis B virus infection in Greek patients with chronic hepatitis C and in patients with diverse nonviral hepatic diseases * , 2004, Journal of viral hepatitis.

[16]  N. Shire,et al.  Occult Hepatitis B in HIV-Infected Patients , 2004, Journal of acquired immune deficiency syndromes.

[17]  P. Bevilacqua,et al.  Occult hepatitis B virus infection does not affect liver histology or response to therapy with interferon alpha and ribavirin in intravenous drug users with chronic hepatitis C. , 2004, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[18]  M. Rizzetto,et al.  Occult hepatitis B virus infection in HBsAg negative patients undergoing liver transplantation: Clinical significance , 2004, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[19]  P. Weinbreck,et al.  Serological pattern ‘anti-hepatitis B core alone’ in HIV or hepatitis C virus-infected patients is not fully explained by hepatitis B surface antigen mutants , 2004, AIDS.

[20]  J. Allain.  Occult hepatitis B virus infection. , 2004, Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine.

[21]  D. Vlahov,et al.  High prevalence of occult hepatitis B in Baltimore injection drug users , 2004, Hepatology.

[22]  J. Marrero,et al.  Occult hepatitis B virus infection in patients with hepatocellular carcinoma: Innocent bystander, cofactor, or culprit? , 2004, Gastroenterology.

[23]  A. McNaghten,et al.  Prevalence of chronic hepatitis B and incidence of acute hepatitis B infection in human immunodeficiency virus-infected subjects. , 2003, The Journal of infectious diseases.

[24]  M. Giordani,et al.  Occult hepatitis B virus infection in HIV/hepatitis C virus co-infected patients. , 2003, AIDS.

[25]  S. A. Gomes,et al.  Frequent Occult Hepatitis B Virus Infection in Patients Infected with Human Immunodeficiency Virus Type 1 , 2003, European Journal of Clinical Microbiology and Infectious Diseases.

[26]  R. Testa,et al.  Previous hepatitis B virus infection is associated with worse disease stage and occult hepatitis B virus infection has low prevalence and pathogenicity in hepatitis C virus‐positive patients , 2003, Liver international : official journal of the International Association for the Study of the Liver.

[27]  V. Soriano,et al.  Lack of 'occult' hepatitis B virus infection in HIV-infected patients. , 2002, AIDS.

[28]  M. Torbenson,et al.  Occult hepatitis B. , 2002, The Lancet. Infectious diseases.

[29]  C. Binquet,et al.  The evolution of hepatitis B virus serological patterns and the clinical relevance of isolated antibodies to hepatitis B core antigen in HIV infected patients. , 2002, Journal of hepatology.

[30]  E. Sagnelli,et al.  Isolated anti‐HBc in chronic hepatitis C predicts a poor response to interferon treatment , 2001, Journal of medical virology.

[31]  H. Doerr,et al.  Hepatitis B virus markers in anti‐HBc only positive individuals * , 2001, Journal of medical virology.

[32]  E. Sagnelli,et al.  CV genotype and “silent” HBV coinfection: Two main risk factors for a more severe liver disease , 2001, Journal of medical virology.

[33]  M. Giordani,et al.  Occult HBV infection in patients with chronic hepatitis C (CHC): frequency and clinical impact , 2001 .

[34]  R. Idilman,et al.  The impact of previous HBV infection on the course of chronic hepatitis C , 2000, American Journal of Gastroenterology.

[35]  C. Müller,et al.  Hepatitis B virus DNA in sera and liver tissue of HBsAg negative patients with chronic hepatitis C. , 2000, Journal of hepatology.

[36]  R. Stauber,et al.  Semiautomated Quantification of Hepatitis B Virus DNA in a Routine Diagnostic Laboratory , 2000, Clinical Diagnostic Laboratory Immunology.

[37]  G. Raimondo,et al.  Occult hepatitis B virus infection in patients with chronic hepatitis C liver disease. , 1999, The New England journal of medicine.

[38]  N. Ishimura,et al.  Serologically silent hepatitis B virus coinfection in patients with hepatitis C virus‐associated chronic liver disease: Clinical and virological significance , 1999, Journal of medical virology.

[39]  M. Rugge,et al.  Intrahepatic expression of hepatitis B virus antigens: effect of hepatitis C virus infection. , 1999, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[40]  M. Loriot,et al.  Influence of human immunodeficiency virus infection on chronic hepatitis B in homosexual men , 1999, Hepatology.

[41]  Y. Sung,et al.  HCV and HBV coexist in HBsAg‐negative patients with HCV viraemia: Possibility of coinfection in these patients must be considered in HBV‐high endemic area , 1997, Journal of gastroenterology and hepatology.

[42]  R. Tedder,et al.  Interactions between HIV and hepatitis B virus in homosexual men: effects on the natural history of infection , 1997, AIDS.

[43]  L. Ferrell,et al.  "Occult" hepatitis B virus as source of infection in liver transplant recipients , 1994, The Lancet.

[44]  S. Chen,et al.  Suppression of hepatitis B virus expression and replication by hepatitis C virus core protein in HuH-7 cells , 1993, Journal of virology.