Limited infection with occult hepatitis B virus in drug users in the USA

Aim: Occult HBV infection (O-HBV) is defined as low level HBV replication in the absence of detectable circulating HBV surface antigen. O-HBV has been implicated in HBV reactivation, advanced liver fibrosis and cirrhosis, reduced interferon response rates, elevated liver enzyme levels, and the development of hepatocellular carcinoma. However, the prevalence of O-HBV has not been clearly established in certain at-risk populations, such as injection drug users. Methods: Therefore, the current pilot study examined the prevalence of O-HBV in a prospective cohort designed to assess the role of injection and non-injection drug use (IDU) on HIV-associated comorbidities. Results: Utilizing two distinct real-time polymerase chain reaction assays, HBV DNA was not detected in 99 participants examined. Conclusion: This finding is in contrast to other data from US IDU cohorts and suggests that the prevalence of O-HBV infection is very specific to the cohort studied, is sensitive to other confounding variables such as hepatitis C virus and/or HIV serostatus, and should not be generalized across risk groups or distinct cohorts.