Occult hepatitis B infection in Portuguese patients with chronic hepatitis C liver disease: prevalence and clinical significance

Introduction Occult hepatitis B virus (HBV) infection, defined as the presence of HBV DNA in the liver (with detectable or undetectable HBV DNA in the serum), has been reported in patients with chronic hepatitis C. Some data suggest its association with a more severe liver disease and a worse response to interferon therapy in this subgroup of patients. However, the clinical significance of this condition is still under debate. Aim To determine the prevalence of occult HBV infection and its clinical significance in patients with chronic hepatitis C liver disease. Materials and methods A prospective analysis of consecutive outpatients with chronic hepatitis C who underwent a liver biopsy recruited between January 2008 and June 2011 was carried out. Data included patient's sex and age, source of hepatitis C virus (HCV) infection, HCV genotype and viral load, presence of serologic markers of previous HBV infection, HBV DNA presence in the liver, histologic findings, and response to interferon and ribavirin treatment. HBV DNA and HCV RNA detection were carried out using a sensitive commercially available PCR kit. HBV DNA was tested in liver samples using a nested PCR procedure. Results One hundred patients were included, 73% men, mean age 49 +/- 11.9 years. Most patients had a genotype 1, with a high viral load, HCV infection. Of the patients, 33% had HBV serologic markers of past infection. The presence of HBV DNA in liver samples was found in 57% of the patients. No statistically significant difference in the epidemiological, histological, or virological or response to therapy data was found in patients with occult HBV infection. Conclusion Occult HBV infection occurred in a high percentage of patients but was not clinically significant. Eur J Gastroenterol Hepatol 25:142-146 (C) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. European Journal of Gastroenterology & Hepatology 2013, 25:142-146