Update on occult hepatitis B virus infection

Area of Science:

• Hepatology
• Virology
• Public Health

Background:

• Occult hepatitis B infection (OBI) is characterized by undetectable hepatitis B surface antigen (HBsAg) but detectable hepatitis B virus (HBV) DNA.
• OBI poses a significant global public health challenge due to its potential to cause cirrhosis and hepatocellular carcinoma.
• While anti-hepatitis B core (anti-HBc) antibodies are key markers, approximately 20% of OBI cases lack anti-HBc, complicating diagnosis.

Purpose of the Study:

• To review the prevalence of OBI globally.
• To focus on the status of OBI in various high-risk populations worldwide.
• To highlight the importance of screening and vaccination strategies for OBI.

Main Methods:

• Diagnosis primarily relies on molecular assays like polymerase chain reaction (PCR) and real-time PCR.
• Real-time PCR is considered more reliable for detecting low levels of HBV DNA characteristic of OBI.
• The review synthesizes data on OBI rates across different geographical regions and risk groups.

Main Results:

• OBI is a significant concern, particularly in specific high-risk groups.
• The persistence of OBI can lead to severe liver complications, including cirrhosis and liver cancer.
• Screening for HBV DNA is recommended for numerous patient categories, including transplant recipients, immunocompromised individuals, and those with liver disease.

Conclusions:

• OBI requires vigilant monitoring and screening, especially in endemic areas and among vulnerable populations.
• Timely HBV vaccination for close relatives of OBI patients is recommended.
• Effective public health strategies are needed to manage the OBI challenge and mitigate its long-term health consequences.