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Wang R, Xue XN, Xiao Y, Liu Y, Yu Y. The prevalence of occult hepatitis B infection among the blood donors in a donation center in Beijing. Diagn Microbiol Infect Dis 2024; 109:116240. [PMID: 38547799 DOI: 10.1016/j.diagmicrobio.2024.116240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 04/30/2024]
Abstract
Occult HBV infection (OBI) remains a potential threat for blood safety. The prevalence of OBI was investigated in a blood donation center of Chinese PLA General Hospital to improve HBV blood safety. 229446 samples from blood donors were screened by two different enzyme-linked immunosorbent assay (ELISA) kits. 78 samples were HBV DNA positive among 212134 ELISA nonreactive donor samples. The prevalence of OBI was 0.04% (76/212134). Ten samples of OBI were permitted by the donors' content for further research, and all of these were below 200IU/mL, and six of these were below 20IU/mL(6/10,60%). Genotype B and genotype C was 20% (2/10) and 80% (8/10), respectively. 16 amino acid mutations were detected in the S region of OBI, included three mutations in MHR region of S. The prevalence of OBI is rare in this donation center. These mutations we found may contribute to the multifactorial occurrence of OBI.
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Affiliation(s)
- Rui Wang
- Department of Blood Transfusion, The first Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xiao-Nan Xue
- Department of Blood Transfusion, The first Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yan Xiao
- Department of Blood Transfusion, The first Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yi Liu
- Department of Blood Transfusion, The first Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yang Yu
- Department of Blood Transfusion, The first Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
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Liu H, Chen S, Liu X, Lou J. Effect of S-region mutations on HBsAg in HBsAg-negative HBV-infected patients. Virol J 2024; 21:92. [PMID: 38654327 DOI: 10.1186/s12985-024-02366-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Occult HBV infection (OBI) is a special form of hepatitis B virus (HBV) infection that may cause Liver cirrhosis and hepatocellular carcinoma, causing significant harm to patients. Given the insidious nature of OBI, it is usually not easy to be detected. Most of the samples currently studied are concentrated on blood donors, however, patients in this special state have not been fully studied. This project aimed to study the effect of HBV S region mutations on HBsAg in patients with clinical OBI. METHODS Collect 107 HBsAg-/HBV DNA + blood samples from Beijing Youan Hospital, Capital Medical University from August 2022 to April 2023. Next, the successfully extracted and amplified HBV DNA S regions were sequenced. Construct mutant plasmids to verify the cell function of the high-frequency mutation sites and explore the possible molecular mechanism. RESULTS Sixty-eight HBsAg-negative samples were sequenced, revealing high-frequency amino acid substitution sites in the HBV S protein, including immune escape mutations (i.e., sY100C、sK122R、sI126T、sT131P、and sS114T) and TMD (Transmembrane domain) region substitutions (i.e., sT5A、sG10D、sF20S、and sS3N). We constructed a portion of the mutant plasmids and found that sT5A, sF20S, sG10D, sS3N, sI68T, and sI126T single point mutations or combined mutations may decrease HBsAg expression or change the antigenicity of HBsAg leading to detection failure. CONCLUSIONS HBsAg-negative patients may show various mutations and amino acid replacement sites at high frequency in the HBV S-region, and these mutations may lead to undetectable Hepatitis B surface antigen (HBsAg), HBsAg antigenic changes or secretion inhibition.
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Affiliation(s)
- Hui Liu
- Clinical Laboratory Center, Beijing Youan Hospital, Capital Medical University, 100069, Beijing, China
| | - Shuxiang Chen
- Clinical Laboratory Center, Beijing Youan Hospital, Capital Medical University, 100069, Beijing, China
| | - Xin Liu
- Clinical Laboratory Center, Beijing Youan Hospital, Capital Medical University, 100069, Beijing, China
| | - Jinli Lou
- Clinical Laboratory Center, Beijing Youan Hospital, Capital Medical University, 100069, Beijing, China.
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Chen J, Ma Z, Wu D, Zuo Q, Wang F, Xiao C, Chen F, Li P. Evaluating the cost-effectiveness of low-level HBV DNA screening in occult hepatitis B infection donors: A study from Shandong Blood Center, China. Heliyon 2023; 9:e18609. [PMID: 37560659 PMCID: PMC10407207 DOI: 10.1016/j.heliyon.2023.e18609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/14/2023] [Accepted: 07/24/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE This study aimed to assess the efficacy of individual-donation nucleic acid testing (ID-NAT) in detecting occult hepatitis B virus infection (OBI) among anti-HBc positive blood donors, compared to minipool nucleic acid testing (MP-NAT). METHODS The present study analyzed data from the Shandong Blood Center in China during the period from January 2018 to June 2022, where HBsAg-negative blood donors were screened using the 6-sample minipool nucleic acid testing (6-sample MP NAT) method. NAT-positive samples underwent subsequent anti-HBc and anti-HBs testing. Approximately 5000 samples that passed the nucleic acid mixing test were randomly selected for anti-HBc testing, and over 100 anti-HBc positive samples underwent individual donor nucleic acid testing (ID-NAT). Any HBV DNA positive samples detected by ID-NAT were subsequently confirmed using alternative nucleic acid testing methods. RESULTS Among 220,445 HBsAg-negative blood donors, the positivity rate of HBV DNA detection using the 6-sample minipool nucleic acid testing (MP NAT) method was found to be 0.031% (69/220,445). Of the 67 HBV DNA positive samples, 55 (82.09%) and 25 (37.31%) were found to be positive for anti-HBc and anti-HBs, respectively, using the supplementary chemiluminescent microparticle immunoassay (CMIA). Among the 4797 HBsAg-negative/MP NAT-negative samples, 909 (18.95%) tested positive for anti-HBc. Further NAT testing was performed on 164 arbitrarily selected anti-HBc-positive/MP HBV DNA-negative samples, revealing a HBV DNA positivity rate of 1.22% (2/164). CONCLUSION Using individual donation nucleic acid testing can significantly increase the detection rate of occult hepatitis B virus infection in anti-HBc-positive blood donors, resulting in a detection rate of 0.22% (1.22 × 0.1895). This rate is 8.10 times higher than the detection rate achieved by mixed testing methods (0.031%) [calculated as (0.22 + 0.031)/0.031]. Therefore, it is recommended to perform single HBV DNA testing on anti-HBc-positive blood donors, discard plasma with weakly positive or negative anti-HBs but positive anti-HBc, or avoid transfusing anti-HBc-positive plasma to recipients with weakly positive or negative anti-HBs to prevent HBV infection.
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Affiliation(s)
- Jianfeng Chen
- Blood Center of Shandong Province, No 22 Shanshi East Road, Lixia District, Jinan, Shandong, China
| | - Zili Ma
- Blood Center of Shandong Province, No 22 Shanshi East Road, Lixia District, Jinan, Shandong, China
| | - Dandan Wu
- Blood Center of Shandong Province, No 22 Shanshi East Road, Lixia District, Jinan, Shandong, China
| | - Qi Zuo
- Blood Center of Shandong Province, No 22 Shanshi East Road, Lixia District, Jinan, Shandong, China
| | - Fengtian Wang
- Blood Center of Shandong Province, No 22 Shanshi East Road, Lixia District, Jinan, Shandong, China
| | - Chen Xiao
- Blood Center of Shandong Province, No 22 Shanshi East Road, Lixia District, Jinan, Shandong, China
| | - Fuqiang Chen
- Blood Center of Shandong Province, No 22 Shanshi East Road, Lixia District, Jinan, Shandong, China
| | - Peng Li
- Blood Center of Shandong Province, No 22 Shanshi East Road, Lixia District, Jinan, Shandong, China
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Gholizadeh O, Akbarzadeh S, Moein M, Yasamineh S, Hosseini P, Afkhami H, Amini P, Dadashpour M, Tahavvori A, Eslami M, Hossein Taherian M, Poortahmasebi V. The role of non-coding RNAs in the diagnosis of different stages (HCC, CHB, OBI) of hepatitis B infection. Microb Pathog 2023; 176:105995. [PMID: 36681203 DOI: 10.1016/j.micpath.2023.105995] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
Despite the availability of an effective hepatitis B virus (HBV) vaccine and universal immunization schedules, HBV has remained a health problem in various stages such as occult hepatitis B infection (OBI), chronic hepatitis B (CHB), and hepatocellular carcinoma (HCC), which is considered one of the possible phases during chronic HBV infection. OBI is defined as the persistence of HBV genomes in hepatocytes of patients with a negative HBV surface antigen (HBsAg) test and detectable or undetectable HBV DNA in the blood. OBI is occasionally associated with infection caused by mutant viruses that produce a modified HBsAg that is undetected by diagnostic procedures or with replication-defective variations. Many aspects of HBV (OBI more than any other stage) including prevalence, pathobiology, and clinical implications has remained controversial. According to a growing body of research, non-coding RNAs (lncRNAs) and microRNAs (miRNAs) have been linked to the development and progression of a number of illnesses, including viral infectious disorders. Despite a shortage of knowledge regarding the expression and biological activities of lncRNAs and miRNAs in HBV infection, Hepatitis B remains a major global public health concern. This review summarizes the role of lncRNAs in the diagnosis and treatment of different stages of hepatitis B infection.
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Affiliation(s)
- Omid Gholizadeh
- Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Virology, Iran University of Medical Sciences, Tehran, Iran
| | - Sama Akbarzadeh
- Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Masood Moein
- Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Saman Yasamineh
- Department of Virology, Iran University of Medical Sciences, Tehran, Iran
| | - Parastoo Hosseini
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Afkhami
- Department of Medical Microbiology, Faculty of Medicine, Shahed University of Medical Science, Tehran, Iran
| | - Paria Amini
- Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Dadashpour
- Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Amir Tahavvori
- Internal Department, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
| | - Majid Eslami
- Department of Bacteriology and Virology, Semnan University of Medical Sciences, Semnan, Iran
| | | | - Vahdat Poortahmasebi
- Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Liu C, Chen K, Zhao F, Xuan L, Wang Y, Xu C, Wu Z, Wang D, Qu C. Occult infection with hepatitis B virus PreS variants synergistically promotes hepatocellular carcinoma development in a high-fat diet context by generating abnormal ceramides. BMC Med 2022; 20:279. [PMID: 36058909 PMCID: PMC9442965 DOI: 10.1186/s12916-022-02481-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 07/14/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Some occult hepatitis B virus (HBV) infections are resulted from PreS mutations that reduce secretion of envelope protein (HBsAg). We investigated the ceramide amounts and species in hepatocytes infected with PreS variants that were isolated from HBsAg-seronegative patients with hepatocellular carcinoma (HCC) and the ceramide effects on autochthonous HCC development in murine models. METHODS HBV PreS/S regions from 35 HBsAg-seronegative HCC patients were sequenced. Hepatocyte cell lines and male C57BL/6J mouse livers were transfected with two PreS variant representatives. The ceramides with variated lengths of fatty acyl chains were quantified. Tumour development was examined in the HBV-transfected mice fed different diet types. RESULTS In HBsAg-seronegative HCC patients, nonneoplastic liver tissues harboured HBsAg and replication-competent HBV. The most frequently detected PreS/S variants carried mutations of altered amino acid properties in HBsAg compared with an isolate from one HBsAg-seronegative HCC patient. Hepatocyte infection with PreS variants caused HBsAg retention within the endoplasmic reticulum and generated more amounts of ceramides with C16:0 ceramide elevated the highest. Saturated fatty acids aggravated the PreS variant-infected hepatocytes to generate abnormal amounts and species of ceramides, which with HBV proteins synergistically activated NLRP3 inflammasome in liver inflammatory macrophages. Liver tumours were only detected in HBV-transfected mice fed high-fat diet, with higher tumour loads in the PreS variant-transfected, associated with abnormal ceramide generation. CONCLUSIONS HBV PreS mutations which altered amino acid properties of envelope proteins inhibited HBsAg secretion. Hepatocyte infection with PreS variants generated abnormal ceramides which with HBV proteins coactivated NLRP3 inflammasome in liver macrophages to promote autochthonous HCC development.
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Affiliation(s)
- Chang Liu
- State Key Lab of Molecular Oncology & Immunology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Kun Chen
- State Key Lab of Molecular Oncology & Immunology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Fei Zhao
- State Key Lab of Molecular Oncology & Immunology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Lingling Xuan
- State Key Lab of Molecular Oncology & Immunology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Yuting Wang
- State Key Lab of Molecular Oncology & Immunology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Chungui Xu
- State Key Lab of Molecular Oncology & Immunology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Zhiyuan Wu
- State Key Lab of Molecular Oncology & Immunology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Dongmei Wang
- State Key Lab of Molecular Oncology & Immunology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Chunfeng Qu
- State Key Lab of Molecular Oncology & Immunology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China.
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Saitta C, Caruso A, Maimone S, Filomia R, Cacciola I, Caccamo G, Franzè MS, Pitrone C, Alibrandi A, Gaeta M, Mandraffino G, Squadrito G, Raimondo G. Antibody to hepatitis B virus core antigen positivity is a predictor of non-alcoholic fatty liver disease severity. Intern Emerg Med 2022; 17:1609-1616. [PMID: 35332431 DOI: 10.1007/s11739-022-02971-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/08/2022] [Indexed: 12/16/2022]
Abstract
Insufficient information is available about co-factors favoring the progression of non-alcoholic fatty liver disease (NAFLD) toward cirrhosis. We aimed to evaluate the impact of a limited alcohol intake and of occult hepatitis B virus (HBV) infection (OBI) on the severity of NAFLD. Three-hundred-seventy-four alcohol non-abusers and HBV surface antigen negative NAFLD patients (223 males; mean age 55.4 years), consecutively admitted to the outpatients clinic of a referral liver unit from January 1st, 2018 to December 31st, 2019, were studied. Anti-HBV core antigen antibody [(anti-HBc), a surrogate marker of OBI] was assessed in all patients. Patients were distinguished between teetotal and moderate alcohol consumers (intake of less than 30 g and 20 g if males or females, respectively). Liver fibrosis was non-invasively assessed by FIB-4 and transient elastography. Uni- and multivariate analyses were performed to identify predictors of advanced fibrosis. Patients had a mean BMI of 28.5 kg/m2, and the majority presented metabolic and cardio-vascular comorbidities [258 patients (69%) had insulin resistance/diabetes, 249 (66.6%) dyslipidemia, 200 (53.5%) arterial hypertension]. Multivariate analysis showed that anti-HBc positivity (p = 0.046, OR 2.153) was a factor associated with advanced fibrosis at FIB-4 score testing, whereas moderate alcohol intake was not associated with severe NAFLD both at FIB-4 and transient elastography evaluations. The study showed that a moderate alcohol intake has no impact on NAFLD severity and suggested that OBI might negatively affect the NAFLD outcome.
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Affiliation(s)
- Carlo Saitta
- Division of Medicine and Hepatology, University Hospital of Messina, Messina, Italy.
- Division of Medicine and Hepatology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 1, 98124, Messina, Italy.
| | - Alessia Caruso
- Division of Medicine and Hepatology, University Hospital of Messina, Messina, Italy
- Division of Medicine and Hepatology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 1, 98124, Messina, Italy
| | - Sergio Maimone
- Division of Medicine and Hepatology, University Hospital of Messina, Messina, Italy
| | - Roberto Filomia
- Division of Medicine and Hepatology, University Hospital of Messina, Messina, Italy
| | - Irene Cacciola
- Division of Medicine and Hepatology, University Hospital of Messina, Messina, Italy
- Division of Medicine and Hepatology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 1, 98124, Messina, Italy
| | - Gaia Caccamo
- Division of Medicine and Hepatology, University Hospital of Messina, Messina, Italy
| | - Maria Stella Franzè
- Division of Medicine and Hepatology, University Hospital of Messina, Messina, Italy
- Division of Medicine and Hepatology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 1, 98124, Messina, Italy
| | - Concetta Pitrone
- Division of Medicine and Hepatology, University Hospital of Messina, Messina, Italy
- Division of Medicine and Hepatology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 1, 98124, Messina, Italy
| | - Angela Alibrandi
- Division of Statistical and Mathematical Sciences, Department of Economics, University of Messina, Messina, Italy
| | - Michele Gaeta
- Division of Diagnostic Imaging, Department of Biomedical and Dental Sciences and of Morphologic and Functional Imaging, University of Messina, Messina, Italy
| | - Giuseppe Mandraffino
- Division of Medicine and Hepatology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 1, 98124, Messina, Italy
- Division of Internal Medicine, University Hospital of Messina, Messina, Italy
| | - Giovanni Squadrito
- Division of Medicine and Hepatology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 1, 98124, Messina, Italy
- Division of Internal Medicine, University Hospital of Messina, Messina, Italy
| | - Giovanni Raimondo
- Division of Medicine and Hepatology, University Hospital of Messina, Messina, Italy
- Division of Medicine and Hepatology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 1, 98124, Messina, Italy
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Xie WY, Sun C, He H, Deng C, Sheng Y. Estimates of the prevalence of occult HBV infection in Asia: a systematic review and meta-analysis. Infect Dis (Lond) 2022; 54:881-896. [PMID: 36047593 DOI: 10.1080/23744235.2022.2115126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
PURPOSE Occult Hepatitis B virus infection (OBI) is of great significance to the transmission of Hepatitis B virus (HBV) and the evolution of the patient's clinical outcome. We conducted a systematic review and meta-analysis to estimate the prevalence of OBI in Asia. METHODS Literature search was conducted in PubMed, Cochrane Library database, Web of Science and Embase with the keywords of 'Hepatitis B virus', 'occult infection', 'prevalence'. 70 studies were included in the meta-analysis. Meta-analysis was performed using random-effects models to calculate the pooled prevalence of OBI and 95% confidence interval (CI). The data were analyzed in R 4.1.2. RESULTS The overall prevalence of OBI was 4% (95%CI: 0.03-0.06) in Asia. Subgroup analysis based on geographic region showed a prevalence of 3% (95%CI 0.02-0.06) in East Asia, 9% (95%CI 0.05-0.15) in West Asia, 3% (95%CI 0.01-0.11) in Southern Asia and 9% (95%CI 0.05-0.15) in Southeast Asia. Subgroup analysis demonstrated a prevalence of 1% (95%CI 0.00-0.02) in general population, 5% (95%CI: 0.03-0.08) in high-risk population, 9% (95%CI: 0.03-0.22) in the human immunodeficiency virus (HIV)-infected patient, 18% (95%CI: 0.09-0.32) in the hepatopathy patients. CONCLUSION Based on the meta-analysis of the prevalence of OBI in different populations, we concluded that the prevalence of OBI in the high-risk population, hepatopathy patients, and HIV-infected patients was higher than that in the general population. A systematic review showed that OBI was associated with disease progression and prognosis. Therefore, these populations should be routinely screened for OBI and promptly intervened to avoid promoting disease progression.
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Affiliation(s)
- Wen Yangyang Xie
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Changfeng Sun
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Infection & Immunity Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hongyan He
- Experimental Teaching Center, School of Public Health of Southwest Medical University, Luzhou, China
| | - Cunliang Deng
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yunjian Sheng
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Infection & Immunity Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Cakal B, Cavus B, Atasoy A, Altunok D, Poda M, Bulakci M, Gulluoglu M, Demirci M, Sener LT, Arslan AB, Arikan M, Akyuz F. Comparison of S gene mutations in patients with occult and chronic hepatitis B virus infection. Virus Res 2022; 318:198855. [PMID: 35798213 DOI: 10.1016/j.virusres.2022.198855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM This study aimed to detect mutations in the HBV S gene and evaluate their relationship to occult hepatitis B virus (HBV) infection (OBI). METHODS The study included 32 patients with negative serum HBsAg and HBV DNA who underwent liver biopsy due to different clinical indications defined as the OBI group and 32 patients who underwent liver biopsy due to chronic hepatitis B (CHB) as the comparison group. The HBV S gene region was amplified by Nested PCR, and Sanger sequencing was performed. RESULTS At least one amino acid (aa) mutation was detected in the major hydrophilic region (MHR) of the HBV S gene in 14/32 (43.75%) of the patients with OBI and 8/32 (25.0%) with CHB. The genotype of all patients with OBI and CHB was HBV/D. Although 9 (28.1%) of the cases with OBI had sub-genotype HBV/D3, none of the patients with CHB had sub-genotype HBV/D3. Unlike patients with CHB, L15*, D33N, Q51P, V63F, L91I, P108S, T115I, P120L, T125M, Q129H, T189I, L216F, P217L mutations were detected in the HBV S gene in OBI cases. Also, P127T aa polymorphism was frequently detected. Mutation frequency in the HBV S gene in the major hydrophilic region (MHR) was higher in patients with OBI with sub-genotypes HBV/D3 and D2 than those with HBV/D1 and those with serotype HBV/ayw3 compared to those with HBV/ayw2 (p < 0.05). CONCLUSIONS Sub-genotypic-specific mutation patterns were seen in the "a" determinant region and T helper cell epitopes of HBsAg, especially in the C-terminus domain; this may be associated with OBI.
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Affiliation(s)
- Bulent Cakal
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul 34093, Turkey.
| | - Bilger Cavus
- Department of Internal Medicine, Istanbul Faculty of Medicine, Division of Gastroenterohepatology, Istanbul University, Istanbul, Turkey
| | - Alp Atasoy
- Department of Internal Medicine, Istanbul Faculty of Medicine, Division of Gastroenterohepatology, Istanbul University, Istanbul, Turkey
| | - Damla Altunok
- Department of Internal Medicine, Istanbul Faculty of Medicine, Division of Gastroenterohepatology, Istanbul University, Istanbul, Turkey
| | - Mehves Poda
- Department of Genetics, Aziz Sancar Institute for Experimental Medical Research, Istanbul University, Istanbul, Turkey
| | - Mesut Bulakci
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mine Gulluoglu
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Demirci
- Department of Medical Microbiology, Faculty of Medicine, Kirklareli University, Kirklareli, Turkey
| | - Leyla Turker Sener
- Department of Biophysics Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | - Muzaffer Arikan
- Regenerative and Restorative Medicine Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Turkey
| | - Filiz Akyuz
- Department of Internal Medicine, Istanbul Faculty of Medicine, Division of Gastroenterohepatology, Istanbul University, Istanbul, Turkey
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Batskikh S, Morozov S, Vinnitskaya E, Sbikina E, Borunova Z, Dorofeev A, Sandler Y, Saliev K, Kostyushev D, Brezgin S, Kostyusheva A, Chulanov V. May Previous Hepatitis B Virus Infection Be Involved in Etiology and Pathogenesis of Autoimmune Liver Diseases? Adv Ther 2022; 39:430-440. [PMID: 34762287 DOI: 10.1007/s12325-021-01983-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/29/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Viral infections, especially with hepatotropic viruses, may trigger autoimmune liver diseases (AILDs) and deteriorate their course. However, association of previous hepatitis B virus (HBV) infection (presence of anti-HBc with or without anti-HBs or HBV DNA in serum) with AILDs is poorly studied so far. The aim of the study was to assess the prevalence of previous hepatitis B virus infection markers and its clinical significance in patients with autoimmune liver diseases. METHODS The study was based on the data obtained from 234 consecutive HBsAg-negative patients with AILDs [81 with autoimmune hepatitis (AIH), 122 with primary biliary cholangitis (PBC) and 31 with primary sclerosing cholangitis (PSC)] and 131 subjects of the control group without liver diseases. Blood samples of the enrolled patients were tested for anti-HBc and HBV DNA. Samples of liver tissue were examined by standard morphologic protocol and, in anti-HBc positive subjects, for HBV DNA. We assessed estimated risks of AILDs according to anti-HBc positivity and association of anti-HBc positivity with stage of liver fibrosis. RESULTS Anti-HBc was detected in 14.5% participants in the control group vs 26.1% (p = 0.016) in patients with AILDs (including 27.1% subjects with PBC (p = 0.021 vs control group), in 29% of PSC and 23.5% in AIH. HBV DNA was detected in three patients with PBC and in one with AIH. Positive anti-HBc test result was associated with higher risk of AILDs-odds ratio (OR) = 2.078 [95% confidence interval (CI) 1.179-3.665], especially in PBC: OR (95% CI) 2.186 (1.165-4.101). Odds of advanced stage of liver fibrosis (F3-F4 by METAVIR) in anti-HBc-positive subjects with PBC were also higher compared to those who had no previous HBV infection: OR (95% CI) 2.614 (1.153-5.926). CONCLUSIONS Significant proportions of patients with AILDs are anti-HBc positive, and some of them have OBI. Among patients with AILDs, anti-HBc-positivity is most widespread in the PBC group and in subjects with advanced stage of liver fibrosis. Our data may support the idea of an important role of previous HBV infection in the etiology and pathogenesis of AILDs (namely PBC).
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Affiliation(s)
- Sergey Batskikh
- Moscow Clinical Scientific Center n.a. A.S. Loginov, Entuziastov Shosse, 86, 111123, Moscow, Russia
| | - Sergey Morozov
- Department Gastroenterology, Hepatology and Nutrition, Federal Research Center of Nutrition and Biotechnology, Kashirskoye Shosse, 21, 115446, Moscow, Russia.
| | - Elena Vinnitskaya
- Moscow Clinical Scientific Center n.a. A.S. Loginov, Entuziastov Shosse, 86, 111123, Moscow, Russia
| | - Evgeniya Sbikina
- Moscow Clinical Scientific Center n.a. A.S. Loginov, Entuziastov Shosse, 86, 111123, Moscow, Russia
| | - Zanna Borunova
- Moscow Clinical Scientific Center n.a. A.S. Loginov, Entuziastov Shosse, 86, 111123, Moscow, Russia
| | - Alexey Dorofeev
- Moscow Clinical Scientific Center n.a. A.S. Loginov, Entuziastov Shosse, 86, 111123, Moscow, Russia
| | - Yulia Sandler
- Moscow Clinical Scientific Center n.a. A.S. Loginov, Entuziastov Shosse, 86, 111123, Moscow, Russia
| | - Kirill Saliev
- Moscow Clinical Scientific Center n.a. A.S. Loginov, Entuziastov Shosse, 86, 111123, Moscow, Russia
| | - Dmitry Kostyushev
- National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health, 127994, Moscow, Russia
- Division of Biotechnology, Scientific Center for Genetics and Life Sciences, Sirius University of Science and Technology, 354340, Sochi, Russia
| | - Sergey Brezgin
- National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health, 127994, Moscow, Russia
- Division of Biotechnology, Scientific Center for Genetics and Life Sciences, Sirius University of Science and Technology, 354340, Sochi, Russia
| | - Anastasiya Kostyusheva
- National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health, 127994, Moscow, Russia
| | - Vladimir Chulanov
- National Medical Research Center of Tuberculosis and Infectious Diseases, Ministry of Health, 127994, Moscow, Russia
- Division of Biotechnology, Scientific Center for Genetics and Life Sciences, Sirius University of Science and Technology, 354340, Sochi, Russia
- Department of Infectious Diseases, Sechenov First Moscow State Medical University, 119146, Moscow, Russia
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10
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Chang KC, Chang MH, Chen HL, Wu JF, Chang CH, Hsu HY, Ni YH. Universal Infant Hepatitis B Virus (HBV) Vaccination for 35 years: moving toward the Eradication of HBV. J Infect Dis 2021; 225:431-435. [PMID: 34363469 DOI: 10.1093/infdis/jiab401] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 08/05/2021] [Indexed: 11/12/2022] Open
Abstract
A universal hepatitis B virus (HBV) vaccination program has been implemented in Taiwan since 1984. 1611 individuals in Taipei were enrolled to monitor long-term efficacy. The prevalences of HBsAg and anti-HBc in the vaccinated birth cohort were lower than those born before 1984 (0.4% vs 7.7%, and 2.2% vs 50.8%, p < .0001; respectively). Three vaccine-failure carriers all were born to HBsAg carrier mothers, probably due to no antiviral intervention during pregnancy. Occult HBV infection was rare in the postvaccination era. High vaccination coverage, comprehensive HBV screening and antiviral agents for pregnant mothers will be essential to eliminate HBV transmission.
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Affiliation(s)
- Kai-Chi Chang
- Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Mei-Hwei Chang
- Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.,Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Huey-Ling Chen
- Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.,Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.,Medical Education and Bioethics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Jia-Feng Wu
- Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Chin-Hao Chang
- Medical Research, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Hong-Yuan Hsu
- Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.,Medical Education and Bioethics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Yen-Hsuan Ni
- Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.,Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
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11
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Chen J, Liu B, Tang X, Zheng X, Lu J, Zhang L, Wang W, Candotti D, Fu Y, Allain JP, Li C, Li L, Li T. Role of core protein mutations in the development of occult HBV infection. J Hepatol 2021; 74:1303-1314. [PMID: 33453326 DOI: 10.1016/j.jhep.2020.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/04/2020] [Accepted: 12/14/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND & AIMS Occult HBV infection (OBI) is associated with transfusion-transmitted HBV infection and hepatocellular carcinoma. Studies on OBI genesis have concentrated on mutations in the S region and the regulatory elements. Herein, we aimed to determine the role of mutations in the core region on OBIs. METHODS An OBI strain (SZA) carrying 9 amino acid (aa) substitutions in the core protein/capsid (Cp) was selected by sequence alignment and Western blot analysis from 26 genotype B OBI samples to extensively explore the impact of Cp mutations on viral antigen production in vitro and in vivo. RESULTS A large panel of 30 Cp replicons were generated by a replication-competent pHBV1.3 carrying SZA or wild-type (WT) Cp in a 1.3-fold over-length of HBV genome, in which the various Cp mutants were individually introduced by repairing site mutations of SZA-Cp or creating site mutations of WT-Cp by site-directed mutagenesis. The expression of HBcAg, HBeAg, and HBsAg and viral RNA was quantified from individual SZA and WT Cp mutant replicons in transfected Huh7 cells or infected mice, respectively. An analysis of the effect of Cp mutants on intracellular or extracellular viral protein production indicated that the W62R mutation in Cp had a critical impact on the reduction of HBcAg and HBeAg production during HBV replication, whereas P50H and/or S74G mutations played a limited role in influencing viral protein production invivo. CONCLUSIONS W62R and its combination mutations in HBV Cp might massively affect HBcAg and HBeAg production during viral replication, which, in turn, might contribute to the occurrence of OBI. LAY SUMMARY Occult hepatitis B virus infections (OBIs) have been found to be associated with amino acid mutations in the S region of the HBV, but the role of mutations in the core protein (Cp) remains unclear. In this study, an OBI strain (SZA) carrying 9 amino acid substitutions in Cp has been examined comprehensively in vitro and in vivo. The W62R mutation in Cp majorly reduces HBcAg and HBeAg production during HBV replication, potentially contributing to the occurrence of OBI.
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Affiliation(s)
- Jingna Chen
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China; Department of Laboratory Medicine, General Hospital of Southern Theatre Command of PLA, Guangzhou, China; Department of Clinical Laboratory, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Bochao Liu
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Xi Tang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China; Department of Infectious Diseases, The First Foshan People's Hospital, Foshan, China
| | - Xin Zheng
- Shenzhen Blood Center, Shenzhen, China
| | - Jinhui Lu
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Ling Zhang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Wenjing Wang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Daniel Candotti
- Department of Blood Transmitted Agents, National Institute of Blood Transfusion, Paris, France
| | - Yongshui Fu
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China; Guangzhou Blood Center, Guangzhou, China
| | - Jean-Pierre Allain
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China; Department of Haematology, University of Cambridge, Cambridge, UK
| | - Chengyao Li
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China.
| | - Linhai Li
- Department of Laboratory Medicine, General Hospital of Southern Theatre Command of PLA, Guangzhou, China.
| | - Tingting Li
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China.
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12
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Piermatteo L, Scutari R, Chirichiello R, Alkhatib M, Malagnino V, Bertoli A, Iapadre N, Ciotti M, Sarmati L, Andreoni M, Ceccherini-Silberstein F, Salpini R, Svicher V. Droplet digital PCR assay as an innovative and promising highly sensitive assay to unveil residual and cryptic HBV replication in peripheral compartment. Methods 2021; 201:74-81. [PMID: 34000391 DOI: 10.1016/j.ymeth.2021.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/29/2021] [Accepted: 05/12/2021] [Indexed: 02/07/2023] Open
Abstract
Droplet digital PCR is an innovative and promising approach for highly sensitive quantification of nucleic acids that is being increasingly used in the field of clinical virology, including the setting of hepatitis B virus (HBV). Here, we comprehensively report a robust and reproducible ddPCR assay for the highly sensitive quantification of serum HBV-DNA. The assay showed a limit of detection of 4 copies/ml (<1IU/ml) by Probit analysis, showed a good linearity (R2 = 0.94) and a high intra- and inter-run reproducibility with differences between the values obtained in the same run or in two independent runs never exceeding 0.14logcopies/mL and 0.21logcopies/mL, respectively. By analysing serum samples from chronically HBV infected patients (mostly under antiviral treatment), ddPCR successfully quantified serum HBV-DNA in 89.8% of patients with detectable serum HBV-DNA < 20 IU/mL [equivalent to <112copies/ml] by classical Real-Time PCR assay, with a median (IQR) of 8(5-14)IU/mL [45(28-78)copies/ml], and in 66.7% of patients with undetectable serum HBV-DNA, with a median (IQR) of 5(4-9)IU/mL [28(20-50)copies/ml]. Similarly, by analysing serum samples from patients with a serological profile compatible with occult HBV infection (anti-HBc+/HBsAg-), ddPCR successfully quantified serum HBV-DNA in 40% of patients with a median (IQR) value of 1(1-2)IU/mL [5(5-11)copies/ml], in line with the extremely limited viral replication typically observed in occult HBV infection. Overall, the availability of assays for the highly sensitive quantification of serum HBV-DNA can provide an added value in optimizing the diagnosis of occult hepatitis B infection, improving the therapeutic management of chronically HBV infected patients, also in the light of innovative drugs (upcoming in clinical practise) aimed at achieving HBV functional cure.
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Affiliation(s)
- Lorenzo Piermatteo
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Rossana Scutari
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Mohammad Alkhatib
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Vincenzo Malagnino
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Ada Bertoli
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy; Laboratory of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Nerio Iapadre
- Infectious Diseases Unit, "San Salvatore Hospital", L' Aquila, Italy
| | - Marco Ciotti
- Laboratory of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Loredana Sarmati
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo Andreoni
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Romina Salpini
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.
| | - Valentina Svicher
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
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13
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Wang R, Liu C, Chen T, Wang Y, Fan C, Lu L, Lu F, Qu C. Neonatal hepatitis B vaccination protects mature adults from occult virus infection. Hepatol Int 2021; 15:328-337. [PMID: 33751394 DOI: 10.1007/s12072-021-10156-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/11/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Among elder children/young adults who received hepatitis B virus (HBV) vaccination during infancy, the serological status of HBsAg-negative and anti-HBc-positive [HBsAg(-)/anti-HBc(+)] was frequently reported, indicating potential occult HBV infection (OBI). It is required to define the long-term protection of neonatal vaccination against OBI in their mature adulthood. METHODS Building upon the 1983-1990 established Qidong Hepatitis B Intervention Study, we sampled 10% of the 28-35-year-old participants, who remained in the cohort by 2012. Each participant was tested for serological markers of HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc. HBV-DNA and relaxed circular DNA (rcDNA) were determined in some HBsAg(-)/anti-HBc(+) individuals. RESULTS Totally, 3615 individuals from the neonatal vaccination group and 3100 individuals from the control group donated blood samples, respectively. In the vaccination group, the prevalence of HBsAg was 1.58% (57/3615), HBsAg(-)/anti-HBc(+) was 4.70% (170/3615), significantly lower than in the control group, which was 7.45% (231/3100) and 19.48% (640/3100) respectively (all p < 0.001). With aging, HBsAg(-)/anti-HBc(+) prevalence increased in the sampled participants from the control group (pfor trend < 0.001), but uncertain from the vaccination group. Of HBsAg(-)/anti-HBc(+), HBV-DNA was detected in 13.08% (17/130) from the vaccination group, and in 4.18% (12/287) from the control group. HBV rcDNA was detected in most sera that were tested positive for HBV-DNA. CONCLUSIONS OBI occurred in some vaccinated adults. However, neonatal HBV vaccination kept the effective protection against OBI in mature adults.
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Affiliation(s)
- Ruijun Wang
- State Key Lab of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Beijing, 100021, People's Republic of China
| | - Chang Liu
- State Key Lab of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Beijing, 100021, People's Republic of China
| | - Taoyang Chen
- Jiangsu, Qidong Liver Cancer Institute & Qidong People's Hospital, Qidong, 226200, People's Republic of China
| | - Yuting Wang
- State Key Lab of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Beijing, 100021, People's Republic of China
| | - Chunsun Fan
- Jiangsu, Qidong Liver Cancer Institute & Qidong People's Hospital, Qidong, 226200, People's Republic of China
| | - Lingling Lu
- Jiangsu, Qidong Liver Cancer Institute & Qidong People's Hospital, Qidong, 226200, People's Republic of China
| | - Fengmin Lu
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, People's Republic of China
| | - Chunfeng Qu
- State Key Lab of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Beijing, 100021, People's Republic of China.
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14
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Xie Q, Ning Q, Wang GQ, Chen CW, Wang FS, Xu XY, Jia JD, Ren H. [Clinical cure strategy for hepatitis B: immunomodulatory therapy]. Zhonghua Gan Zang Bing Za Zhi 2020; 28:649-653. [PMID: 32911900 DOI: 10.3760/cma.j.cn501113-20200722-00410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Chronic hepatitis B virus (HBV) infection remains a major world public health problem. Current guidelines of chronic hepatitis B (CHB) suggest the clinical cure as the ideal thearapeutic goal. Although the optimization of the existing antiviral treatment can make some patients achieve clinical cure, but for most patients with chronic hepatitis B, it is difficult to achieve clinical cure according to the existing antiviral treatment plan. The medical community has begun to work together to seek new treatment strategies, especially the immune intervention measures aimed at restoring the immune response in the liver microenvironment. Notably, immune antiviral response plays a crucial role in HBV clearance, and the clinical cure of chronic hepatitis B is finally achieved through the optimized combination of antiviral and immunomodulatory drugs.
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Affiliation(s)
- Q Xie
- Department of Infectious Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China
| | - Q Ning
- Department of Infectious Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - G Q Wang
- Department of Infectious Diseases and Center for Liver Diseases, Peking University First Hospital; Department of Infectious Diseases and Liver Diseases, Peking University Internatianal Hospital, Beijing 100034, China
| | - C W Chen
- The 905th Hospital of the Chinese People's Liberation Army Navy, Shanghai 200235, China
| | - F S Wang
- Treatment and Research Center for Infectious Diseases, the Fifth Medical Center of PLA General Hospital, Beijing 100039, China
| | - X Y Xu
- Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China
| | - J D Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Diseases; Beijing 100050, China
| | - H Ren
- The Second Affiliated Hospital of Chongqing Medical University, Institute for Viral Hepatitis, Chongqing Medical University, Chongqing 400010, China
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15
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Chen XX, Xiang KH, Zhang HP, Kong XS, Huang CY, Liu YM, Lou JL, Gao ZH, Yan HP. Occult HBV infection in patients with autoimmune hepatitis: A virological and clinical study. Journal of Microbiology, Immunology and Infection 2020; 53:946-954. [DOI: 10.1016/j.jmii.2019.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/10/2019] [Accepted: 04/26/2019] [Indexed: 02/06/2023]
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16
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Aluora PO, Muturi MW, Gachara G. Seroprevalence and genotypic characterization of HBV among low risk voluntary blood donors in Nairobi, Kenya. Virol J 2020; 17:176. [PMID: 33187530 PMCID: PMC7666503 DOI: 10.1186/s12985-020-01447-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/05/2020] [Indexed: 12/23/2022] Open
Abstract
Background Hepatitis B virus (HBV) causes significant morbidity and mortality globally primarily due to its ability to cause hepatitis, liver cirrhosis and hepatocellular carcinoma. The Kenya National Blood Transfusion Services screens for Hepatitis B antibodies using the chemiluminescent microparticle immunoassay method. This test does not inform on the genotypic characteristics of the virus or the actual presence of the virus in blood. This study therefore sought to determine the serologic and genotypic profiles of HBV circulating among the voluntary blood donors in Nairobi. Methods Blood samples were collected in plain and EDTA vacutainers and tested for the Hepatitis B surface antigen (HBsAg). HBV DNA was then extracted from plasma, its overlapping P/S gene amplified and sequenced. The resulting sequences were used to analyze for the circulating genotypes and mutations within the P and S genes. Bivariate statistical analysis was used to determine the association between demographic factors and HBV infection. Results A seroprevalence of 2.3% (n = 7) was reported. The age group 19–28 years was significantly associated with HBV infection. Nine samples were positive for HBV DNA; these included 2 HBsAg positive samples and 7 HBsAg negative samples. Genotype A, sub genotype A1 was found to be exclusively prevalent while a number of mutations were reported in the “a” determinant segment of the major hydrophilic region of the S gene associated with antibody escape. RT mutations including mutation rt181T in the P gene conferring resistance against Lamivudine and other ʟ-nucleoside drugs were detected. Conclusion There is a high prevalence of occult HBV infections among these blood donors and therefore the testing platform currently in use requires revision.
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Affiliation(s)
- Patrick Okoti Aluora
- Department of Health and Applied Sciences, Nairobi Technical Training Institute, Nairobi, Kenya. .,Department of Medical Laboratory Science, Kenyatta University, Nairobi, Kenya.
| | | | - George Gachara
- Department of Medical Laboratory Science, Kenyatta University, Nairobi, Kenya
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17
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Wang J, Liu Y, Liao H, Liu L, Chen R, Si L, Luo D, Huang B, Li L, Jiang J, Xu D. The sK122R mutation of hepatitis B virus (HBV) is associated with occult HBV infection: Analysis of a large cohort of Chinese patients. J Clin Virol 2020; 130:104564. [PMID: 32763811 DOI: 10.1016/j.jcv.2020.104564] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 07/09/2020] [Accepted: 07/28/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Occult HBV infection (OBI) is of great concern due to their complicated diagnosis and potential for public transmission. OBJECTIVE The study aimed to determine the clinical prevalence of OBI and if viral immune escape-associated mutations contribute to the occurrence of OBI. STUDY DESIGN A total of 91,037 HBV-infected patients with different related illnesses who were admitted to the Fifth Medical Center of Chinese PLA General Hospital from January 2005 to December 2017 were tested for OBI. Serum samples from 62 patients with OBI manifestations (OBI patients) and 124 matched non-OBI patients were sequenced for possible immune escape-associated mutations within the major hydrophilic region of HBV S protein. HBsAg and HBV DNA levels in representative viral strains were measured. RESULTS Of the 91,037 tested patients, 487 (0.53 %) were negative for HBsAg but positive for HBV DNA and were defined as OBI patients. The prevalence in different illness categories varied. Immune escape-associated mutations were more frequently detected in OBI patients than in non-OBI patients (59.68 % vs. 35.48 %, P < 0.01), as did the coexistence of multiple mutations (43.55 % vs. 22.58 %, P < 0.01). Specifically, the prevalence rates of sT118 K, sK122R, and sV168A were increased in OBI patients. Strains with sK122R mutants (sK122R, sK122R + D144E, sK122R + C121R + D144E, and sK122R + F134L + D144E) from a follow-up OBI patient all showed significantly lower levels of HBsAg production than a wild-type strain. CONCLUSIONS The study clarified the clinical prevalence of OBI, verified the influence of immune escape-associated mutations, and identified the role of the sK122R mutation in multiple OBI patients.
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18
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Pronier C, Candotti D, Boizeau L, Bomo J, Laperche S, Thibault V. The contribution of more sensitive hepatitis B surface antigen assays to detecting and monitoring hepatitis B infection. J Clin Virol 2020; 129:104507. [PMID: 32570044 DOI: 10.1016/j.jcv.2020.104507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hepatitis B surface antigen (HBsAg) remains the main viral marker for screening and monitoring hepatitis B virus (HBV) infection. The quantification limit of most current HBsAg assays is around 0.05 IU/mL. The Lumipulse-G-HBsAg-Quant assay (Fujirebio) claims to obtain a tenfold improvement in sensitivity. This study aimed to assess the performance of this assay in detecting low HBsAg levels in clinical samples. METHODS Three panels of stored frozen samples were selected on the basis of HBV-DNA and HBsAg values obtained previously with routine techniques. Panels 1 (n=13) and 2 (n=52) consisted of DNA-positive/HBsAg-negative samples from individuals in the window period and with occult HBV infection respectively. Panel 3 comprised 23 samples with low or discrepant HBsAg screening results. All these samples were tested retrospectively with the DiaSorin and Fujirebio HBsAg assays. RESULTS Sixteen out of 65 samples (25 %), initially screened HBsAg negative, were reactive only with the Fujirebio assay (median value= 0.015 IU/mL; IQR= 0.012): three (23 %) samples from panel 1 and 13 (25 %) from panel 2. Thirteen of these 16 (81 %) had HBsAg values below 0.03 IU/mL with the DiaSorin assay. In panel 3, 22 (96 %) samples were quantified successfully with the Fujirebio assay (median: 0.32 IU/mL; IQR: 1.20) and 19 (83 %) with the DiaSorin assay (median: 0.31 IU/mL; IQR: 0.65). Concentrations obtained with the two assays showed good correlations (r=0.893, Spearman). CONCLUSIONS HBsAg assays with enhanced analytical sensitivity could improve HBV serological profile interpretation with possible consequences on clinical management of infected patients, and on blood transfusion safety.
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Affiliation(s)
- Charlotte Pronier
- Univ Rennes, Department of Virology, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
| | - Daniel Candotti
- Department of Blood-borne Agents, National Reference Center of Infectious Risks in Blood Transfusion, Institut National de la Transfusion Sanguine, Paris, France
| | - Laure Boizeau
- Department of Blood-borne Agents, National Reference Center of Infectious Risks in Blood Transfusion, Institut National de la Transfusion Sanguine, Paris, France
| | - Jérémy Bomo
- Univ Rennes, Department of Virology, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France
| | - Syria Laperche
- Department of Blood-borne Agents, National Reference Center of Infectious Risks in Blood Transfusion, Institut National de la Transfusion Sanguine, Paris, France
| | - Vincent Thibault
- Univ Rennes, Department of Virology, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000, Rennes, France.
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Zhuge S, Ge C, Yang Y, Cui Y, Yue X, Zhang Z, Xu H, Huang A, Zhao Y. The prevalence of occult HBV infection in immunized children with HBsAg-positive parents: a hospital-based analysis. Hepatol Int 2020; 14:503-512. [PMID: 32472310 PMCID: PMC7259741 DOI: 10.1007/s12072-020-10055-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 05/11/2020] [Indexed: 12/15/2022]
Abstract
Background and object The risk of occult HBV infection (OBI) in children whose mothers are HBV carriers has received more widespread attention, but there were few reports to focus on the children with HBsAg-positive parents. In this study, we aimed to investigate the prevalence of OBI in immunized children with HBsAg-positive parents. Methods HBV-vaccinated Chinese hospitalized children with HBsAg-positive parents were analyzed in our investigation. Eligible subjects were tested using a standard nested PCR for all HBV genes, and analyzed by direct sequencing. Results There were 327 HBsAg-negative children included in the study out of about 9800 involved HBV-vaccinated hospitalized children. The positive rate of OBI was 3.1% (10/327) in the eligible children and 14.1% (46/327) with HBV DNA detectable. No significant differences were found between one and at least two regions positive groups (p > 0.05). The proportions of HBV DNA detectable in children with HBV father-carriers and mother-carriers were similar. The risk factors for HBV DNA-positive children could be male, anti-HBs levels, and anti-HBc positive. Conclusion There are 3.1% of OBIs and 14.1% of suspected OBI in vaccinated children with HBsAg-positive parents. The potential risk of suspected OBI in children with HBsAg-positive father should not be ignored. Anti-HBc positivity may be a useful seromarker for suspected OBI screening in vaccinated children. To prevent HBV breakthrough infection, accurate and convenient method is needed to detect OBI timely and exhaustively. Electronic supplementary material The online version of this article (10.1007/s12072-020-10055-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shurui Zhuge
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
- Department of Pediatric Intensive Care Unit, Taihe Hospital, Hubei University of Medicine, Hubei, China
| | - Congcong Ge
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Yuting Yang
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Yuxia Cui
- Department of Pediatrics, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
| | - Xiaomei Yue
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Zhenzhen Zhang
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Hongmei Xu
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Ailong Huang
- Ministry of Education Key Laboratory of Molecular Biology On Infectious Diseases, Institute for Viral Hepatitis, Chongqing Medical University, Chongqing, China
| | - Yao Zhao
- National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China.
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Raimondo G, Locarnini S, Pollicino T, Levrero M, Zoulim F, Lok AS. Update of the statements on biology and clinical impact of occult hepatitis B virus infection. J Hepatol 2019; 71:397-408. [PMID: 31004683 DOI: 10.1016/j.jhep.2019.03.034] [Citation(s) in RCA: 278] [Impact Index Per Article: 55.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/20/2019] [Accepted: 03/28/2019] [Indexed: 02/06/2023]
Abstract
In October 2018 a large number of international experts with complementary expertise came together in Taormina to participate in a workshop on occult hepatitis B virus infection (OBI). The objectives of the workshop were to review the existing knowledge on OBI, to identify issues that require further investigation, to highlight both existing controversies and newly emerging perspectives, and ultimately to update the statements previously agreed in 2008. This paper represents the output from the workshop.
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Affiliation(s)
- Giovanni Raimondo
- Division of Clinical and Molecular Hepatology, University of Messina, Messina, Italy; Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
| | - Stephen Locarnini
- Victorian Infectious Diseases Reference Laboratory at the Doherty Institute, Melbourne, Victoria, Australia
| | - Teresa Pollicino
- Division of Clinical and Molecular Hepatology, University of Messina, Messina, Italy; Department of Human Pathology, University of Messina, Messina, Italy
| | - Massimo Levrero
- Cancer Research Center of Lyon, INSERM U1052, Hospices Civils de Lyon, Lyon University, Lyon, France
| | - Fabien Zoulim
- Cancer Research Center of Lyon, INSERM U1052, Hospices Civils de Lyon, Lyon University, Lyon, France
| | - Anna S Lok
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
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21
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Caviglia GP, Tandoi F, Olivero A, Saracco GM, Rizzetto M, Romagnoli R, Smedile A. Quantitation of anti-HBe antibodies in anti-HBc-positive liver donors. J Hepatol 2019; 70:793-795. [PMID: 30591262 DOI: 10.1016/j.jhep.2018.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 12/04/2022]
Affiliation(s)
- Gian Paolo Caviglia
- Department of Medical Sciences, University of Turin, Gastroenterology Division of Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy.
| | - Francesco Tandoi
- General Surgery 2U, Liver Transplant Center - A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Antonella Olivero
- Department of Medical Sciences, University of Turin, Gastroenterology Division of Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy
| | - Giorgio Maria Saracco
- Department of Medical Sciences, University of Turin, Gastroenterology Division of Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy
| | - Mario Rizzetto
- Department of Medical Sciences, University of Turin, Gastroenterology Division of Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy
| | - Renato Romagnoli
- General Surgery 2U, Liver Transplant Center - A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Antonina Smedile
- Department of Medical Sciences, University of Turin, Gastroenterology Division of Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy
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22
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Caviglia GP, Abate ML, Tandoi F, Ciancio A, Amoroso A, Salizzoni M, Saracco GM, Rizzetto M, Romagnoli R, Smedile A. Quantitation of HBV cccDNA in anti-HBc-positive liver donors by droplet digital PCR: A new tool to detect occult infection. J Hepatol 2018; 69:301-307. [PMID: 29621551 DOI: 10.1016/j.jhep.2018.03.021] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 03/10/2018] [Accepted: 03/13/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS The accurate diagnosis of occult hepatitis B virus (HBV) infection (OBI) requires the demonstration of HBV DNA in liver biopsies of hepatitis B surface antigen-negative individuals. However, in clinical practice a latent OBI is deduced by the finding of the antibody to the hepatitis B core antigen (anti-HBc). We investigated the true prevalence of OBI and the molecular features of intrahepatic HBV in anti-HBc-positive individuals. METHODS The livers of 100 transplant donors (median age 68.2 years; 64 males, 36 females) positive for anti-HBc at standard serologic testing, were examined for total HBV DNA by nested-PCR and for the HBV covalently closed circular DNA (HBV cccDNA) with an in-house droplet digital PCR assay (ddPCR) (Linearity: R2 = 0.9998; lower limit of quantitation and detection of 2.4 and 0.8 copies/105 cells, respectively). RESULTS A total of 52% (52/100) of the individuals studied were found to have OBI. cccDNA was found in 52% (27/52) of the OBI-positive, with a median 13 copies/105 cells (95% CI 5-25). Using an assay specific for anti-HBc of IgG class, the median antibody level was significantly higher in HBV cccDNA-positive than negative donors (17.0 [7.0-39.2] vs. 5.7 [3.6-9.7] cut-off index [COI], respectively, p = 0.007). By multivariate analysis, an anti-HBc IgG value above 4.4 COI was associated with the finding of intrahepatic HBV cccDNA (odds ratio 8.516, p = 0.009); a lower value ruled out its presence with a negative predictive value of 94.6%. CONCLUSIONS With a new in-house ddPCR-based method, intrahepatic HBV cccDNA was detectable in quantifiable levels in about half of the OBI cases examined. The titer of anti-HBc IgG may be a useful surrogate to predict the risk of OBI reactivation in immunosuppressed patients. LAY SUMMARY The covalently closed circular DNA (cccDNA) form of the hepatitis B virus (HBV) sustains the persistence of the virus even decades after resolution of the symptomatic infection (occult HBV infection). In the present study we developed a highly sensitive method based on droplet digital PCR technology for the detection and quantitation of HBV cccDNA in the liver of individuals with occult HBV infection. We observed that the amount of HBV cccDNA may be inferred from the titer in serum of the IgG class antibody to the hepatitis B core antigen. The quantitation of this antibody may represent a surrogate to determine which patients are at the highest risk of HBV reactivation following immunosuppressive therapies.
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Affiliation(s)
- Gian Paolo Caviglia
- Department of Medical Sciences, University of Turin, Gastroenterology Division of Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy.
| | - Maria Lorena Abate
- Department of Medical Sciences, University of Turin, Gastroenterology Division of Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy
| | - Francesco Tandoi
- General Surgery 2U, Liver Transplant Center - A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alessia Ciancio
- Department of Medical Sciences, University of Turin, Gastroenterology Division of Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy
| | - Antonio Amoroso
- Regional Transplant Center, Piedmont, A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, Turin, Italy
| | - Mauro Salizzoni
- General Surgery 2U, Liver Transplant Center - A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Giorgio Maria Saracco
- Department of Medical Sciences, University of Turin, Gastroenterology Division of Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy
| | - Mario Rizzetto
- Department of Medical Sciences, University of Turin, Gastroenterology Division of Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy
| | - Renato Romagnoli
- General Surgery 2U, Liver Transplant Center - A.O.U. Città della Salute e della Scienza di Torino, Molinette Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Antonina Smedile
- Department of Medical Sciences, University of Turin, Gastroenterology Division of Città della Salute e della Scienza of Turin, University Hospital, Turin, Italy
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Ha J, Park Y, Kim HS. Evaluation of clinical sensitivity and specificity of hepatitis B virus (HBV), hepatitis C virus, and human immunodeficiency Virus-1 by cobas MPX: Detection of occult HBV infection in an HBV-endemic area. J Clin Virol 2017; 96:60-3. [PMID: 28982042 DOI: 10.1016/j.jcv.2017.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 08/13/2017] [Accepted: 09/18/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Transfusion-transmitted infectious diseases remain a major concern for blood safety, particularly with hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Nucleic acid testing (NAT) in donor screening shortens the serologically negative window period and reduces virus transmission. The cobas MPX (Roche Molecular Systems, Inc., Branchburg, New Jersey) is a recently developed multiplex qualitative PCR system that enables the simultaneous detection of HBV, HCV, and HIV with improved sensitivity and throughput using cobas 6800 and 8800 instruments. OBJECTIVES The aim of this study was to conduct an evaluation of the clinical sensitivity and specificity of cobas MPX detection of HBV, HCV, and HIV in clinical specimens. STUDY DESIGN Among samples referred for HBV, HCV, and HIV-1 quantification at Severance Hospital, Yonsei University College of Medicine, positive samples were selected to evaluate sensitivity. A total of 843 samples was tested using both cobas MPX and COBAS AmpliPrep/COBAS TaqMan Tests for HBV, HCV, and HIV-1 using the cobas 8800 system and a COBAS TaqMan 96 analyzer, respectively. Samples that showed discrepancies were confirmed by nested PCR. CONCLUSIONS The cobas MPX achieved excellent sensitivity and specificity for the detection of HBV, HCV, and HIV-1 in clinical samples. We found that the lower limit of detection (LOD) of blood screening by NAT actually improves clinical sensitivity, and occult HBV infection prevalence among healthy employees of the hospital was rather high.
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Varaklioti A, Kouramba A, Ioannidou P, Katsarou O. Occult hepatitis B virus infection in Greek patients with congenital bleeding disorders. Infect Genet Evol 2017; 54:397-401. [PMID: 28705716 DOI: 10.1016/j.meegid.2017.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 06/20/2017] [Accepted: 07/09/2017] [Indexed: 01/04/2023]
Abstract
Occult Hepatitis B Infection (OBI) is a form of chronic HBV infection characterized by low level HBV DNA, without detectable HBV surface antigen (HBsAg). OBI is frequently associated with the presence of anti-HBc and in some cases also with anti-HBs. Patients, who formerly received non-inactivated factor concentrates, can potentially be considered at high risk for OBI, especially since these patients usually are HIV or HCV co-infected. This study aimed to assess the prevalence of occult HBV infection in Greek patients with hereditary bleeding disorders. The study sample comprised of 114 patients from a single haemophilia center. All patients were screened for HBV serum markers and individually tested for HBV DNA using a qualitative PCR. Presence of HBV DNA was further confirmed by quantification of viral load with an ultrasensitive in-house real time PCR. 88 and 21 patients with haemophilia A and B, respectively, 4 patients with von Willebrand Disease and 1 patient with severe factor VII deficiency were screened for the presence of OBI. Anti-HBc were detected in 53 (46.5%) subjects; 18 of them were anti-HBs(-) and 35 anti-HBs(+). Anti-HBe were present in 26 subjects. Two out of 114 patients were HBsAg(+). Of the remaining 112 HBsAg(-) patients tested, two (1.8%) were found HBsAg(-), HBV DNA(+), anti-HBc(+) and anti-HBs(-) and were identified as potential OBI cases. Both cases exhibited very low DNA levels; 38.2IU/mL in patient A and 14.2IU/mL in patient B. Both patients were HBeAg(-), but patient A had HBe antibodies. Patient B was also HIV/HCV co-infected. In conclusion, two cases of OBI with low HBV viraemia were identified among patients with congenital bleeding disorders. Although the incidence in our sample is moderately low (1.8%), close monitoring of these infections is of great clinical significance, especially in patients with co-infections and concomitant immunosuppression.
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Affiliation(s)
- Agoritsa Varaklioti
- Blood Center and National Reference Center for Congenital Bleeding Disorders, Laiko General Hospital, Agiou Thoma 17, 11527 Athens, Greece; Faculty of Social Sciences, Department of Health Management, Hellenic Open University, Patras, Greece
| | - Anna Kouramba
- Blood Center and National Reference Center for Congenital Bleeding Disorders, Laiko General Hospital, Agiou Thoma 17, 11527 Athens, Greece
| | - Panagiota Ioannidou
- Blood Center and National Reference Center for Congenital Bleeding Disorders, Laiko General Hospital, Agiou Thoma 17, 11527 Athens, Greece
| | - Olga Katsarou
- Blood Center and National Reference Center for Congenital Bleeding Disorders, Laiko General Hospital, Agiou Thoma 17, 11527 Athens, Greece.
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Candotti D, Boizeau L, Laperche S. Occult hepatitis B infection and transfusion-transmission risk. Transfus Clin Biol 2017; 24:189-195. [PMID: 28673499 DOI: 10.1016/j.tracli.2017.06.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 06/07/2017] [Indexed: 02/07/2023]
Abstract
Advances in serology and viral nucleic acid testing (NAT) over the last decades significantly reduced the risk of transfusion-transmitted hepatitis B virus (HBV). The combination of HBsAg testing and NAT efficiently prevents the majority of HBV transmission. However, a specific residual risk remains associated with extremely low viral DNA levels in blood donors with occult HBV infection (OBI) that are intermittently or not detectable even by highly sensitive individual donation (ID) NAT. Studies have reported HBV transfusion-transmission with blood components from donors with OBI that contained low amount of viruses (<200 virions). HBV transfusion-transmission seems to depend on a combination of several factors including the volume of plasma associated with the infected blood components transfused, the anti-HBV immune status of both recipient and donor, and possibly the viral fitness of the infecting HBV strain. Models based on clinical and experimental evidences estimate a residual transmission risk of 3-14% associated with OBI donations testing HBsAg and ID-NAT non-reactive. Anti-HBc testing has the potential to improve further blood safety but it may also compromise blood availability in settings with medium/high HBV prevalence. Pathogen reduction procedures might be considered.
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Affiliation(s)
- D Candotti
- Département d'études des agents transmissibles par le sang, institut national de la transfusion sanguine, centre national de référence risques infectieux transfusionnels, 6, rue Alexandre-Cabanel, 75015 Paris, France.
| | - L Boizeau
- Département d'études des agents transmissibles par le sang, institut national de la transfusion sanguine, centre national de référence risques infectieux transfusionnels, 6, rue Alexandre-Cabanel, 75015 Paris, France
| | - S Laperche
- Département d'études des agents transmissibles par le sang, institut national de la transfusion sanguine, centre national de référence risques infectieux transfusionnels, 6, rue Alexandre-Cabanel, 75015 Paris, France
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Kim MH, Kang SY, Lee WI. Occult HBV among Anti-HBc Alone: Mutation Analysis of an HBV Surface Gene and Pre-S Gene. Yonsei Med J 2017; 58:557-563. [PMID: 28332361 PMCID: PMC5368141 DOI: 10.3349/ymj.2017.58.3.557] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 12/23/2016] [Accepted: 01/26/2017] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The aim of this study is to investigate the molecular characteristics of occult hepatitis B virus (HBV) infection in 'anti-HBc alone' subjects. MATERIALS AND METHODS Twenty-four patients with 'anti-HBc alone' and 20 control patients diagnosed with HBV were analyzed regarding S and pre-S gene mutations. All specimens were analyzed for HBs Ag, anti-HBc, and anti-HBs. For specimens with an anti-HBc alone, quantitative analysis of HBV DNA, as well as sequencing and mutation analysis of S and pre-S genes, were performed. RESULTS A total 24 were analyzed for the S gene, and 14 were analyzed for the pre-S gene through sequencing. A total of 20 control patients were analyzed for S and pre-S gene simultaneously. Nineteen point mutations of the major hydrophilic region were found in six of 24 patients. Among them, three mutations, S114T, P127S/T, M133T, were detected in common. Only one mutation was found in five subjects of the control group; this mutation was not found in the occult HBV infection group, however. Pre-S mutations were detected in 10 patients, and mutations of site aa58-aa100 were detected in 9 patients. A mutation on D114E was simultaneously detected. Although five mutations from the control group were found at the same location (aa58-aa100), no mutations of occult HBV infection were detected. CONCLUSION The prevalence of occult HBV infection is not low among 'anti-HBc alone' subjects. Variable mutations in the S gene and pre-S gene were associated with the occurrence of occult HBV infection. Further larger scale studies are required to determine the significance of newly detected mutations.
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Affiliation(s)
- Myeong Hee Kim
- Department of Laboratory Medicine, Kyung Hee University School of Medicine and Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - So Young Kang
- Department of Laboratory Medicine, Kyung Hee University School of Medicine and Kyung Hee University Hospital at Gangdong, Seoul, Korea.
| | - Woo In Lee
- Department of Laboratory Medicine, Kyung Hee University School of Medicine and Kyung Hee University Hospital at Gangdong, Seoul, Korea
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Rodríguez Lay LDLA, Bello Corredor M, Montalvo Villalba MC, Chibás Ojeda AG, Sariego Frómeta S, Diaz González M, Abad Lamoth Y, Sánchez Wong M, Sausy A, Muller CP, Hübschen JM. Hepatitis B virus infection assessed 3 to 18 years after vaccination in Cuban children and adolescents born to HBsAg-positive mothers. Arch Virol 2017; 162:2393-2396. [PMID: 28439708 DOI: 10.1007/s00705-017-3365-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 03/15/2017] [Indexed: 12/31/2022]
Abstract
Thirty-two participants, aged between 3-18 years, born to hepatitis B surface antigen (HBsAg)-positive mothers and vaccinated at birth were analyzed for hepatitis B virus (HBV) infection. Overall, 56% had anti-HB titers ≥10 IU/L; five were positive for antibodies to the core antigen (anti-HBc), and two of these were also positive for HBsAg/DNA. One of the HBsAg/anti-HBc double-negative children presented with an unusual occult infection (HBV DNA-positive). No known vaccine escape mutations were detectable. Our data suggest that the vaccine protected 93.8% of children in this high-risk group against chronic HBV infection. Occult infections should be considered even in countries with low endemicity and high vaccination coverage.
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Affiliation(s)
- Licel de Los Angeles Rodríguez Lay
- Institute of Tropical Medicine Pedro Kourí (IPK), Department of Virology, National Reference Laboratory on Viral Hepatitis, Autopista Novia del Mediodía, Km 61/2, La Lisa, Marianao 13, PO Box 601, Havana, Cuba.
| | - Marité Bello Corredor
- Institute of Tropical Medicine Pedro Kourí (IPK), Department of Virology, National Reference Laboratory on Viral Hepatitis, Autopista Novia del Mediodía, Km 61/2, La Lisa, Marianao 13, PO Box 601, Havana, Cuba
| | - Maria Caridad Montalvo Villalba
- Institute of Tropical Medicine Pedro Kourí (IPK), Department of Virology, National Reference Laboratory on Viral Hepatitis, Autopista Novia del Mediodía, Km 61/2, La Lisa, Marianao 13, PO Box 601, Havana, Cuba
| | - Annia Gertrudis Chibás Ojeda
- Institute of Tropical Medicine Pedro Kourí (IPK), Department of Virology, National Reference Laboratory on Viral Hepatitis, Autopista Novia del Mediodía, Km 61/2, La Lisa, Marianao 13, PO Box 601, Havana, Cuba
| | - Susel Sariego Frómeta
- Institute of Tropical Medicine Pedro Kourí (IPK), Department of Virology, National Reference Laboratory on Viral Hepatitis, Autopista Novia del Mediodía, Km 61/2, La Lisa, Marianao 13, PO Box 601, Havana, Cuba
| | - Manuel Diaz González
- Institute of Tropical Medicine Pedro Kourí (IPK), Department of Virology, National Reference Laboratory on Viral Hepatitis, Autopista Novia del Mediodía, Km 61/2, La Lisa, Marianao 13, PO Box 601, Havana, Cuba
| | - Yoandra Abad Lamoth
- Institute of Tropical Medicine Pedro Kourí (IPK), Department of Virology, National Reference Laboratory on Viral Hepatitis, Autopista Novia del Mediodía, Km 61/2, La Lisa, Marianao 13, PO Box 601, Havana, Cuba
| | - Meilin Sánchez Wong
- Institute of Tropical Medicine Pedro Kourí (IPK), Department of Virology, National Reference Laboratory on Viral Hepatitis, Autopista Novia del Mediodía, Km 61/2, La Lisa, Marianao 13, PO Box 601, Havana, Cuba
| | - Aurélie Sausy
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, 29, rue Henri Koch, L-4354, Esch-Sur-Alzette, Grand Duchy of Luxembourg
| | - Claude P Muller
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, 29, rue Henri Koch, L-4354, Esch-Sur-Alzette, Grand Duchy of Luxembourg
| | - Judith M Hübschen
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health, 29, rue Henri Koch, L-4354, Esch-Sur-Alzette, Grand Duchy of Luxembourg
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Sagnelli C, Macera M, Pisaturo M, Zampino R, Coppola M, Sagnelli E. Occult HBV infection in the oncohematological setting. Infection 2016; 44:575-82. [PMID: 27076347 DOI: 10.1007/s15010-016-0891-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 03/07/2016] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Occult hepatitis B infection (OBI), a virological condition characterized by a low release of Hepatitis B Virus (HBV) from liver cells and low HBV-DNA levels in serum and/or liver tissue of HBsAg-negative subjects, may reactivate in oncohematological patients undergoing immunosuppression by aggressive chemotherapy or hematopoietic stem cell transplantation. The entity of OBI reactivation varies from an increase in HBV replication without liver damage to an active HBV replication followed by liver cell necrosis, frequently severe and in some cases life threatening. Because of a possible severe outcome associated with OBI reactivation (hepatic failure or death due to the discontinuation of chemotherapy), prophylaxis with anti-HBV nucleot(s)ide analogues is recommended in relation to the foreseeable degree of immunosuppression. MATERIALS AND METHODS This review article focuses on the clinical impact of OBI in the oncohematological setting and is addressed to all health care workers having in care oncohematological patients or involved in the treatment of HBV infection and OBI prophylaxis. CONCLUSION International guidelines have indicated lamivudine prophylaxis in hematopoietic stem cell transplantation and when high-dose corticosteroids or anti-CD20 or anti-CD52 monoclonal antibodies are used. Entecavir or tenofovir should replace lamivudine for patients with advanced liver diseases for whom reactivation of OBI may be life threatening. When anti-CD20 or anti-CD52 sparing schedules or other non-aggressive chemotherapies are used, monitoring may be indicated, but very early treatment with highly effective antiviral drugs (entecavir or tenofovir) should be administered once a reactivation of OBI has occurred.
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Affiliation(s)
- C Sagnelli
- Department of Clinical and Experimental Medicine and Surgery "F. Magrassi e A. Lanzara", Second University of Naples, 80131, Naples, Italy
| | - M Macera
- Azienda Ospedaliera Universitaria-Second University of Naples, 80131, Naples, Italy
| | - M Pisaturo
- Division of Infectious Diseases, AORN Sant'Anna e San Sebastiano di Caserta, 81100, Caserta, Italy
| | - R Zampino
- Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Second University of Naples, 80131, Naples, Italy
| | - M Coppola
- Section of Infectious Diseases, Department of Mental Health and Public Medicine, Second University of Naples, Via: L. Armanni 5, 80131, Naples, Italy
| | - E Sagnelli
- Section of Infectious Diseases, Department of Mental Health and Public Medicine, Second University of Naples, Via: L. Armanni 5, 80131, Naples, Italy.
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Spreafico M, Berzuini A, Foglieni B, Candotti D, Raffaele L, Guarnori I, Colli A, Maldini FF, Allain JP, Prati D. Poor efficacy of nucleic acid testing in identifying occult HBV infection and consequences for safety of blood supply in Italy. J Hepatol 2015; 63:1068-76. [PMID: 26116791 DOI: 10.1016/j.jhep.2015.06.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 04/30/2015] [Accepted: 06/16/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND & AIMS In Italy, DNA screening of blood donations for hepatitis B virus (HBV) was introduced to prevent the transmission of window period and occult HBV infection. Anti-HBc screening is not recommended in order to avoid shortage of the blood supply. To contain costs, donor samples are generally pooled before testing. We evaluated the safety of this national policy using a prospective repository of donors/recipient pairs. METHODS We used highly sensitive nucleic acid testing (NAT) assays to test repository and follow-up samples from donors who were initially classified as negative by minipool NAT assays (6-MP), but were later found to carry occult HBV DNA. When available, we also analysed recipients' pre- and post-transfusion samples, collected in the context of a repository financed by the European Commission (the BOTIA project). RESULTS Between 2008 and 2011 6-MP NAT assays identified 18 carriers of occult HBV infection among 12,695 donors; 28 samples from previous donations were available from 13 of these carriers. Highly sensitive HBV DNA detection methods showed that 6-MP HBV DNA screening failed to identify 14/28 (50%) viraemic donations, that were released for transfusion. HBV marker testing of such blood product recipients revealed two cases of transfusion transmitted HBV infection, documented by donor-recipient sequence identity. CONCLUSIONS Viraemic blood donations from occult HBV infection carriers remain undetected by current minipool HBV DNA screening, and transfusion transmission of HBV continues to occur in susceptible patients. More effective individual HBV DNA screening and/or tests for antibodies to HBV core antigen should be considered to improve blood safety.
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Affiliation(s)
- Marta Spreafico
- Department of Transfusion Medicine and Hematology, Azienda Ospedaliera della Provincia di Lecco, Alessandro Manzoni Hospital, Lecco, Italy.
| | - Alessandra Berzuini
- Department of Transfusion Medicine and Hematology, Azienda Ospedaliera della Provincia di Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - Barbara Foglieni
- Department of Transfusion Medicine and Hematology, Azienda Ospedaliera della Provincia di Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - Daniel Candotti
- Institut National de la Transfusion Sanguine (INTS), Département d'études des agents transmissibles, F-75015 Paris, France
| | - Livia Raffaele
- Department of Transfusion Medicine and Hematology, Azienda Ospedaliera della Provincia di Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - Irene Guarnori
- Department of Transfusion Medicine and Hematology, Azienda Ospedaliera della Provincia di Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - Agostino Colli
- Department of General Medicine, Azienda Ospedaliera della Provincia di Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | - Francesco Fumagalli Maldini
- Department of Transfusion Medicine and Hematology, Azienda Ospedaliera della Provincia di Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | | | - Daniele Prati
- Department of Transfusion Medicine and Hematology, Azienda Ospedaliera della Provincia di Lecco, Alessandro Manzoni Hospital, Lecco, Italy.
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Amponsah-Dacosta E, Lebelo RL, Rakgole JN, Selabe SG, Gededzha MP, Mayaphi SH, Powell EA, Blackard JT, Mphahlele MJ. Hepatitis B virus infection in post-vaccination South Africa: occult HBV infection and circulating surface gene variants. J Clin Virol 2015; 63:12-7. [PMID: 25600597 DOI: 10.1016/j.jcv.2014.11.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 11/19/2014] [Accepted: 11/24/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of this study was to investigate the prevalence of occult hepatitis B virus (HBV) infection and the HBV surface (S) gene variants circulating in the South African population after nearly two decades of universal hepatitis B vaccination. STUDY DESIGN From a previous serosurvey, 201 serum samples with serological evidence of exposure to HBV were identified and these were stratified into post- and pre-vaccine introduction populations. For all samples, HBV DNA was screened and quantified using a real-time PCR assay and results analysed together with HBV serological markers. Where HIV results were available, subset analysis was performed. The HBV S gene was PCR-amplified and sequences analysed for a total of 37 isolates. RESULTS The prevalence of occult HBV infection reduced from 70.4% in the pre-vaccine introduction era to 66.0% post-vaccine introduction. There was an association between HIV infection and an increase in prevalence of occult HBV infection within the post-vaccine introduction population, although this was not statistically significant. Furthermore, sequence analysis revealed the following HBV subgenotypes; A1 (n=34), A2 (n=2) and a rare D4 isolate. HBV S gene variants, including diagnostic escape mutants were isolated. CONCLUSION There was a decline in the prevalence of occult HBV infection in post-vaccination South Africa, although the disease burden remains significant in the HIV co-infected population. After nearly two decades of a universal hepatitis B vaccination programme, no positive selection of vaccine escape mutants were observed.
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Yousif M, Mudawi H, Hussein W, Mukhtar M, Nemeri O, Glebe D, Kramvis A. Genotyping and virological characteristics of hepatitis B virus in HIV-infected individuals in Sudan. Int J Infect Dis 2014; 29:125-32. [PMID: 25449246 DOI: 10.1016/j.ijid.2014.07.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 06/19/2014] [Accepted: 07/02/2014] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) share common routes of blood-borne transmission. In HBV mono-infected Sudanese individuals, genotypes D, E, and A circulate. The objective of this study was to molecularly characterize HBV from HBV/HIV co-infected individuals. METHODS The polymerase overlapping the S region and the basic core promoter (BCP/PC) of HBV from 32 hepatitis B surface antigen (HBsAg)-positive and 18 HBsAg-negative serum samples were amplified and sequenced. RESULTS HBV from 37 samples was successfully genotyped and the genotype distribution was 46.0% D, 21.6% E, 18.9% A, and 13.5% D/E recombinant. Compared to mono-infected individuals, the frequencies of the D/E recombinant and genotype A were higher in HBV/HIV co-infected patients, as was the intra-group divergence of genotype E. BCP/PC mutations affecting hepatitis B e antigen (HBeAg) expression at the transcriptional and translational levels were detected. Two HBsAg-positive individuals had pre-S deletion mutants. The following mutations in the S region could account for the HBsAg negativity: sM133T, sE164G, sV168G, and sS174N. No primary drug resistance mutations were found. CONCLUSIONS In HBV/HIV co-infected Sudanese patients, the ratio of genotype A to non-A was higher than that in mono-infected patients. The genotype E intra-group divergence in HBV/HIV co-infected individuals was significantly higher than that in HBV mono-infected patients.
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Affiliation(s)
- Mukhlid Yousif
- Hepatitis Virus Diversity Research Programme, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa
| | - Hatim Mudawi
- Department of Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Waleed Hussein
- Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | - Maowia Mukhtar
- Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | - Omer Nemeri
- College of Medicine, Bahri University, Khartoum, Sudan
| | - Dieter Glebe
- Institute of Medical Virology, National Reference Centre of Hepatitis B and D, Justus Liebig-University of Giessen, Giessen, Germany
| | - Anna Kramvis
- Hepatitis Virus Diversity Research Programme, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa.
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Aghasadeghi MR, Banifazl M, Aghakhani A, Eslamifar A, Vahabpour R, Ramezani A. No evidence for occult HBV infection in hepatitis B vaccine non-responders. Iran J Microbiol 2014; 6:350-3. [PMID: 25848527 PMCID: PMC4385577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Although hepatitis B vaccine immunogenicity is high, certain risk factors such as age, tobacco consumption, obesity and genetic background have been associated with low responsiveness to HBV vaccine. We aimed to evaluate the role of occult hepatitis B virus (HBV) infection in non-responder adults to HBV vaccine in a low endemic area for HBV. MATERIAL AND METHODS A total of 52 subjects who were non-responder to HBV vaccine were enrolled in the study. HBsAg, anti-HBs and anti-HBc were tested in all subjects. The presence of HBV-DNA was determined in plasma samples by real-time PCR. RESULTS A total of 52 cases with median age 34 years were enrolled in the study. 63.5% of patients were male and 36.5% were female. Isolated anti-HBc (HBsAg negative, anti-HBs negative and anti-HBc positive) was detected in 3.8% of cases. HBV-DNA was not detected in our cases. CONCLUSION This study showed no evidence of occult HBV infection in our HBV vaccine non-responders even in cases with isolated anti-HBc.
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Affiliation(s)
| | - Mohammad Banifazl
- Iranian Society for Support of Patients with Infectious Diseases, Tehran, Iran
| | - Arezoo Aghakhani
- Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran
| | - Ali Eslamifar
- Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran
| | | | - Amitis Ramezani
- Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran,Corresponding author: Amitis Ramezani, Address: Clinical Research Dept. Pasteur Institute of Iran; No 69, Pasteur Ave., Tehran, 13164, Iran, Tel: +982166968852, Fax: +982166968852,
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Han Z, Liu Y, Pan J, Bi Y, Liu J, Zhou YH. Occult hepatitis B virus infection with positive hepatitis B e antigen. Clin Chim Acta 2015; 438:266-8. [PMID: 25218700 DOI: 10.1016/j.cca.2014.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 09/03/2014] [Accepted: 09/04/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Hepatitis B e antigen (HBeAg) is a marker to indicate active replication of hepatitis B virus (HBV). Occult HBV infection (OBI), referred to persistence of HBV DNA in serum and/or liver without detectable serum hepatitis B surface (HBsAg), usually has low HBV DNA levels. The presence of HBeAg in OBI is unusual. METHODS We report 2 patients who presented negative for HBsAg but positive for HBeAg and HBV DNA. HBV markers were quantified in the longitudinal sera in a period of 1-2years. The HBV DNA sequences were analyzed in 2 patients' sera and 1 patient's liver. RESULTS Both patients were also positive for total anti-HBs and anti-HBc but negative for anti-HBe and anti-HBc IgM. HBV DNA levels were 234-567IU/ml in case 1 and 42-1130IU/ml in case 2. The alignment analysis of the S gene showed that HBV in both patients was genotype C, serotype adr. Cloning analysis of the a determinant of HBsAg showed that the immune escape mutants were predominant in both patients over the follow-up period. The HBV had double mutations (A1762T and G1764A) in the basal core promoter but had no mutation in the pre C/C gene in both patients. CONCLUSIONS The patients with negative HBsAg but positive HBeAg may represent a unique type of OBI. Test for HBeAg would be critical to identifying such type of OBI.
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Affiliation(s)
- Teresa Pollicino
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy; Department of Pediatric, Gynecologic, Microbiology and Biomedical Science, University Hospital of Messina, Messina, Italy.
| | - Giovanni Raimondo
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy; Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy.
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Inuzuka T, Ueda Y, Morimura H, Fujii Y, Umeda M, Kou T, Osaki Y, Uemoto S, Chiba T, Marusawa H. Reactivation from occult HBV carrier status is characterized by low genetic heterogeneity with the wild-type or G1896A variant prevalence. J Hepatol 2014; 61:492-501. [PMID: 24798622 DOI: 10.1016/j.jhep.2014.04.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 04/07/2014] [Accepted: 04/24/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Individuals negative for hepatitis B surface antigen (HBsAg) but positive for antibodies to hepatitis B core antigen (anti-HBc) are at risk of hepatitis B virus (HBV) reactivation under immunosuppressive conditions. We investigated clinical features and viral genetics in patients with reactivation from occult HBV infection triggered by chemotherapy or immunosuppressive therapy. METHODS Clinical courses of 14 individuals originally HBsAg-negative but anti-HBc-positive that experienced HBV reactivation were examined. Ultra-deep sequencing analysis of the entire HBV genome in serum was conducted. Prevalence of the G1896A variant in latently infected livers was determined among 44 healthy individuals that were HBsAg-negative but anti-HBc-positive. RESULTS In 14 cases, HBV reactivation occurred during (n=7) and after (n=7) termination of immunosuppressive therapy. Ultra-deep sequencing revealed that the genetic heterogeneity of reactivated HBV was significantly lower in patients with reactivation from occult HBV carrier status compared with that in patients from HBsAg carrier status. The reactivated viruses in each case were almost exclusively the wild-type G1896 or G1896A variant. The G1896A variant was detected in 42.9% (6/14) of cases, including two cases with fatal liver failure. The G1896A variant was observed in the liver tissue of 11.4% (5/44) of individuals with occult HBV infection. CONCLUSIONS Reactivation from occult HBV infection is characterized by low genetic heterogeneity, with the wild-type G1896 or G1896A variant prevalent.
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Affiliation(s)
- Tadashi Inuzuka
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshihide Ueda
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Morimura
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yosuke Fujii
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Makoto Umeda
- Department of Gastroenterology and Hepatology, Hyogo Prefectural Amagasaki Hospital, Hyogo, Japan
| | - Tadayuki Kou
- Department of Gastroenterology and Hepatology, Kitano Hospital, Osaka, Japan
| | - Yukio Osaki
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Shinji Uemoto
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsutomu Chiba
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroyuki Marusawa
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Pollicino T, Cacciola I, Saffioti F, Raimondo G. Hepatitis B virus PreS/S gene variants: pathobiology and clinical implications. J Hepatol 2014; 61:408-17. [PMID: 24801416 DOI: 10.1016/j.jhep.2014.04.041] [Citation(s) in RCA: 186] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 04/21/2014] [Accepted: 04/24/2014] [Indexed: 12/16/2022]
Abstract
The emergence and takeover of hepatitis B virus (HBV) variants carrying mutation(s) in the preS/S genomic region is a fairly frequent event that may occur spontaneously or may be the consequence of immunoprophylaxis or antiviral treatments. Selection of preS/S mutants may have relevant pathobiological and clinical implications. Both experimental data and studies in humans show that several specific mutations in the preS/S gene may induce an imbalance in the synthesis of the surface proteins and their consequent retention within the endoplasmic reticulum (ER) of the hepatocytes. The accumulation of mutated surface proteins may cause ER stress with the consequent induction of oxidative DNA damage and genomic instability. Viral mutants with antigenically modified surface antigen may be potentially infectious to immune-prophylaxed patients and may account for cases of occult HBV infection. In addition, preS/S variants were reported to be associated with cases of fulminant hepatitis as well as of fibrosing cholestatic hepatitis, and they are associated with cirrhosis and hepatocellular carcinoma development.
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Coffin CS, Mulrooney-Cousins PM, Osiowy C, van der Meer F, Nishikawa S, Michalak TI, van Marle G, Gill MJ. Virological characteristics of occult hepatitis B virus in a North American cohort of human immunodeficiency virus type 1-positive patients on dual active anti-HBV/HIV therapy. J Clin Virol 2014; 60:347-53. [PMID: 24881491 DOI: 10.1016/j.jcv.2014.04.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 03/10/2014] [Accepted: 04/25/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Occult hepatitis B virus infection (OBI) is defined as low-level HBV DNA presence in serum, liver and/or peripheral blood mononuclear cells (PBMC) in individuals that lack serum hepatitis B virus surface antigen (HBsAg). HIV+ patients with OBI may be at risk for HBV reactivation, and often receive dual active anti-HBV/HIV therapy, such as lamivudine (LMV). OBJECTIVES To determine the presence of OBI in a North American cohort of HIV-1-positive patients. STUDY DESIGN/METHODS 45 HIV-1-positive, serum HBsAg-negative patients, reactive for antibodies to HBV core antigen (anti-HBc), were tested for HBV DNA in plasma and for HBV DNA and covalently closed circular DNA (cccDNA) in PBMC. Ten patients were re-tested after ∼5-10 years, including genotyping and clonal sequence analysis of the HBV polymerase (P) gene and overlapping HBV surface (S) gene from 8 PBMC samples. RESULTS Overall, 42% (19/45) tested HBV DNA positive, especially in PBMC (18/45), including 3/18 that were reactive for HBV cccDNA, compared to 17% (8/45) that were HBV DNA reactive in plasma. In 8 patients on LMV, sequence analysis in PBMC showed that all were HBV genotype C or D. Several carried HBV P region variants at residues associated with anti-HBV drug resistance and overlapping S gene region within the major HBsAg "a determinant". CONCLUSION OBI is common in HIV-positive, anti-HBc reactive patients on anti-HBV/HIV therapy, particularly in PBMC. HBV sequence analysis revealed that all had HBV genotype C or D and often had P/overlapping S gene variants possibly associated with dual-active anti-HIV/HBV therapy.
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Affiliation(s)
- Carla S Coffin
- Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Microbiology, Immunology and Infectious Diseases, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Patricia M Mulrooney-Cousins
- Molecular Virology and Hepatology Research Group, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Carla Osiowy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Frank van der Meer
- Department of Microbiology, Immunology and Infectious Diseases, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; Faculty of Veterinary Medicine, University of Calgary, AB, Canada
| | - Sandra Nishikawa
- Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Microbiology, Immunology and Infectious Diseases, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tomasz I Michalak
- Molecular Virology and Hepatology Research Group, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Guido van Marle
- Department of Microbiology, Immunology and Infectious Diseases, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - M John Gill
- Department of Microbiology, Immunology and Infectious Diseases, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
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Saitta C, Musolino C, Marabello G, Martino D, Leonardi MS, Pollicino T, Altavilla G, Raimondo G. Risk of occult hepatitis B virus infection reactivation in patients with solid tumours undergoing chemotherapy. Dig Liver Dis 2013; 45:683-6. [PMID: 23490344 DOI: 10.1016/j.dld.2013.01.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 12/12/2012] [Accepted: 01/27/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hepatitis B virus reactivation may occur in occult-infected carriers with haematological malignancies, whereas little data are available in patients undergoing chemotherapy for solid tumours. AIMS Evaluation of cancer patients undergoing chemotherapy to investigate occult hepatitis B virus infection and its clinical-virological outcome. METHODS Forty-four patients with solid tumours and without liver disease were prospectively enrolled and sampled before starting chemotherapy and between the second and third chemotherapy cycles (time points 1 and 2, respectively); 24 were also sampled 6 months after the end of chemotherapy (time point 3). At each time point, subjects were tested for liver biochemistry, hepatitis B serology and occult infection. RESULTS No sample tested positive for virus surface antigen. Twelve subjects (27.3%) were antibody positive to hepatitis B virus. Overall, occult infection was detected in 4 cases (9%), with positive HBV DNA at time points 1 and 2 (one case), at time point 1 only (one case), only at time points 2 and 3 (two cases), respectively. No occult-infected carrier experienced liver biochemistry flares and/or viral surface antigen positivity. CONCLUSIONS Occult hepatitis B virus infection may occur in subjects with solid tumours, although the risk of its reactivation under chemotherapy appears to be very low.
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Affiliation(s)
- Carlo Saitta
- Division of Clinical and Molecular Hepatology, Department of Internal Medicine, University Hospital of Messina, Messina, Italy
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Coppola N, Loquercio G, Tonziello G, Azzaro R, Pisaturo M, Di Costanzo G, Starace M, Pasquale G, Cacciapuoti C, Petruzziello A. HBV transmission from an occult carrier with five mutations in the major hydrophilic region of HBsAg to an immunosuppressed plasma recipient. J Clin Virol 2013; 58:315-7. [PMID: 23856167 DOI: 10.1016/j.jcv.2013.06.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Revised: 06/11/2013] [Accepted: 06/12/2013] [Indexed: 02/09/2023]
Abstract
We describe the case of transmission of an HBsAg-negative hepatitis B infection to an immunosuppressed patient by plasma donation from an HBsAg-negative subject, but with very low serum HBV DNA (about 50 IU/ml) and five mutations in the major hydrophilic region of HBsAg.
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Affiliation(s)
- Nicola Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Naples, Italy.
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Bhattacharya P, Chandra PK, Datta S, Banerjee A, Chakraborty S, Rajendran K, Basu SK, Bhattacharya SK, Chakravarty R. Significant increase in HBV, HCV, HIV and syphilis infections among blood donors in West Bengal, Eastern India 2004-2005: Exploratory screening reveals high frequency of occult HBV infection. World J Gastroenterol 2007; 13:3730-3. [PMID: 17659734 PMCID: PMC4250646 DOI: 10.3748/wjg.v13.i27.3730] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the prevalence of markers of hepatitis B virus (HBV) and hepatitis C virus (HCV) and human immunodeficiency virus (HIV) among blood donors in Kolkata, Eastern India for two consecutive years and to conduct a pilot study to explore the presence of HBV DNA among hepatitis B surface antigen (HBsAg) negative but anti-HBc positive blood donors.
METHODS: Seroprevalence of HBsAg, anti-HCV and anti-HIV was studied among 113 051 and 106 695 voluntary blood donors screened in 2004 and 2005, respectively. Moreover, a pilot study on 1027 HBsAg negative donors was carried out for evaluating the presence of HBV DNA by PCR on HBsAg negative/anti-HBc positive donors.
RESULTS: A statistically significant increase in the prevalence of HBV (1448 vs 1768, P < 0.001), HIV (262 vs 374, P < 0.001), HCV (314 vs 372, P = 0.003) and syphilis (772 vs 853, P = 0.001) infections was noted among blood donors of Kolkata West Bengal in 2005 as compared to 2004. Moreover, the exploratory study on 1027 HBsAg negative donors revealed that 188 (18.3%) of them were anti-HBc positive out of which 21% were positive for HBV DNA.
CONCLUSION: The findings of this study underscore the significantly increasing endemicity of hepatitis viruses, syphilis and HIV among the voluntary blood donors of our community. The pilot study indicates a high rate of prevalence of HBV DNA among HBsAg negative/anti-HBc positive donors and thus emphasizes the need for a more sensitive and stringent screening algorithm for blood donations.
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Affiliation(s)
- Prasun Bhattacharya
- Institute of Blood Transfusion Medicine and Immunohematology, Kolkata, India
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Abstract
AIM: To study the prevalence and clinical effects of occult HBV infection in haemodialysis patients with chronic HCV.
METHODS: Fifty chronic hemodialysis patients with negative HbsAg, and positive anti-HCV were included in the study. These patients were divided into two groups: HCV-RNA positive and HCV-RNA negative, based on the results of HCV-RNA PCR. HBV-DNA was studied using the PCR method in both groups.
RESULTS: None of the 22 HCV-RNA positive patients and 28 HCV-RNA negative patients revealed HBV-DNA in serum by PCR method. The average age was 47.2 ± 17.0 in the HCV-RNA positive group and 39.6 ± 15.6 in the HCV-RNA negative group.
CONCLUSION: The prevalence of occult HBV infection is not high in haemodialysis patients with chronic HCV in our region. This result of our study has to be evaluated in consideration of the interaction between HBsAg positivity (8%-10%) and frequency of HBV mutants in our region.
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Affiliation(s)
- Vedat Goral
- Department of Gastroenterology, Dicle University School of Medicine, Diyarbakir, Turkey.
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Abstract
AIM: To investigate the prevalence and clinical significance of “anti-HBc alone” in an unselected population of patients and employees of a university hospital in southern Germany.
METHODS: All individuals with the pattern “anti-HBc alone” were registered over a time span of 82 mo. HBV-DNA was measured in serum and liver samples, and clinical charts were reviewed.
RESULTS: Five hundred and fifty two individuals were “anti-HBc alone” (of 3004 anti-HBc positive individuals; 18.4%), and this pattern affected males (20.5%) more often than females (15.3%; P < 0.001). HBV-DNA was detected in serum of 44 of 545 “anti-HBc alone” individuals (8.1%), and in paraffin embedded liver tissue in 16 of 39 patients tested (41.0%). There was no association between the detection of HBV genomes and the presence of biochemical, ultrasonic or histological signs of liver damage. Thirty-eight “anti-HBc alone” patients with cirrhosis or primary liver carcinoma had at least one additional risk factor. HCV-coinfection was present in 20.4% of all individuals with “anti-HBc alone” and was the only factor associated with a worse clinical outcome.
CONCLUSION: In an HBV low prevalence area, no evidence is found that HBV alone causes severe liver damage in individuals with “anti-HBc alone”. Recommendations for the management of these individuals are given.
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Affiliation(s)
- Antje Knöll
- Institute of Medical Microbiology and Hygiene, University of Regensburg, D-93042 Regensburg, Germany.
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