Skip Navigation LinksHome > March 1, 2007 - Volume 44 - Issue 3 > The Prevalence and Significance of Occult Hepatitis B Virus...
JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0b013e31802e29a9
Epidemiology and Social Science

The Prevalence and Significance of Occult Hepatitis B Virus in a Prospective Cohort of HIV-Infected Patients

Shire, Norah J MPH*†; Rouster, Susan D BS*; Stanford, Sandra D BS*; Blackard, Jason T PhD*; Martin, Christina M BS*; Fichtenbaum, Carl J MD‡; Sherman, Kenneth E MD, PhD*

Collapse Box

Abstract

Background: Occult hepatitis B virus (HBV) is defined as low-level HBV DNA without hepatitis B surface antigen (HBsAg). Prevalence estimates vary widely. We determined the prevalence of occult HBV at the University of Cincinnati Infectious Diseases Center (IDC).

Methods: Patients in the IDC HIV database (n = 3867) were randomly selected using a 25% sampling fraction. Samples were pooled for HBV nucleic acid extraction. Pools were tested for HBV DNA by a real-time polymerase chain reaction (PCR) assay to coamplify core/surface protein regions. The PCR assay was run on all individual samples from each DNA+ pool. DNA+ samples were tested for HBV serologic markers.

Results: A total of 909 patients without known HBV were selected. The mean CD4 count was 384 cells/mm3. Forty-three patients were HBV DNA+. Twelve of 43 were DNA+/HBsAg (95% confidence interval for database: 0.58% to 1.90%). Five of 12 were negative for all serologic markers. Alanine aminotransferase, aspartate aminotransferase, and HBV DNA titers were elevated in HBsAg+ patients versus occult patients and versus HIV-monoinfected patients. No other significant differences were detected. No occult HBV patient was on treatment with anti-HBV activity.

Conclusions: Forty-three percent of those with HBV were not previously identified as HBV+, indicating the need for ongoing screening in high-risk populations. Occult HBV may occur in persons with all negative serologic markers, representing a challenge for identification.

© 2007 Lippincott Williams & Wilkins, Inc.

Login

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.