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Antibody to hepatitis B core antigen as a screening test for occult hepatitis B virus infection in Egyptian chronic hepatitis C patients

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Purpose

The presence of hepatitis B virus (HBV) DNA in liver tissue and/or in serum in the absence of detectable hepatitis B surface antigen (HBsAg) is called occult HBV infection. This pattern was identified in patients with chronic hepatitis C virus (HCV) infection. The aim of this study was to determine the role of antibodies to hepatitis B core antigen (anti-HBc) as a screening test for occult HBV infection in Egyptian chronic HCV patients.

Methods

One hundred chronic HCV patients negative for HBsAg were included and subdivided into two groups according to anti-HBc-IgG seroreactivity. Group A included 71 patients positive for anti-HBc (53 men and 18 women, mean age ± SD 48.8 ± 9.6 years), and group B included 29 patients negative for anti-HBc (18 men and 11 women, mean age ± SD 46.6 ± 11.7 years). All patients were subjected to full clinical assessment, routine laboratory investigations, abdominal ultrasonography and quantification of HBV-DNA by real-time PCR.

Results

Chronic HCV patients positive for anti-HBc have more severe liver disease compared with anti-HBc negative patients. Although HBV-DNA in the serum was detected in 22.5% of anti-HBc-positive chronic HCV patients, it was not detected in any of anti-HBc-negative chronic HCV patients. There was no significant difference in any of the clinical and laboratory data tested between anti-HBc-positive patients with and without HBV-DNA in the serum.

Conclusion

A significant number of patients with anti-HBc had detectable levels of HBV-DNA in the serum. Egyptian chronic HCV patients have a high prevalence of occult HBV infection.

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References

  1. Lavanchy D, McMahon B. Worldwide prevalence and prevention of hepatitis C. In: Liang TJ, Hoofnagle JH, editors. Hepatitis C. San Diego: Academic Press; 2000. p. 185–202.

    Google Scholar 

  2. World Health Organization (1995) Inter-country workshop on the prevention and control of Viral Hepatitis. Cairo, Egypt, 16–20 April. WHO regional Office, EMRO. EM/EPD/92/E.

  3. Ray SC, Arthur RR, Carella A, Bukh J, Thomas DL. Genetic epidemiology of hepatitis C virus throughout Egypt. J Infect Dis. 2000;182:698–707.

    Article  PubMed  CAS  Google Scholar 

  4. Saudy N, Sugauchi F, Tanaka Y, Suzuki S, Aal A, Zaid MA, et al. Genotypes and phylogenetic characterization of hepatitis B and delta viruses in Egypt. J Med Virol. 2003;70:529–36.

    Article  PubMed  CAS  Google Scholar 

  5. Marusawa H, Osaki Y, Kimura T, Ito K, Yamashita Y, Eguchi T, et al. High prevalence of anti-hepatitis B virus serological markers in patients with hepatitis C virus related chronic liver disease in Japan. Gut. 1999;45:284–8.

    Article  PubMed  CAS  Google Scholar 

  6. Brechot C, Thiers V, Kremsdorf D, Nalpas B, Pol S, Paterlini-Brechot P. Persistent hepatitis B virus infection in subjects without hepatitis B surface antigen: clinically significant or purely “occult”? Hepatology. 2001;34:194–203.

    Article  PubMed  CAS  Google Scholar 

  7. Cacciola I, Pollicino T, Squadrito G, Cerenzia G, Orlando ME, Raimondo G. Occult hepatitis B virus infection in patients with chronic hepatitis C liver disease. N Engl J Med. 1999;341:22–6.

    Article  PubMed  CAS  Google Scholar 

  8. Fukuda R, Ishimura N, Niigaki M, Hamamoto S, Satoh S, Tanaka S. Serologically silent hepatitis B virus coinfection in patients with hepatitis C virus-associated chronic liver disease: clinical and virological significance. J Med Virol. 1999;58:201–7.

    Article  PubMed  CAS  Google Scholar 

  9. Georgiadou SP, Zachou K, Rigopoulou E, Liaskos C, Mina P, Gerovasilis F, et al. Occult hepatitis B virus infection in Greek patients with chronic hepatitis C and in patients with diverse nonviral hepatic diseases. J Viral Hepat. 2004;11:358–65.

    Article  PubMed  CAS  Google Scholar 

  10. Sagnelli E, Coppola N, Scolastico C, Ar Mogavero, Filippini P, Piccinino F. HCV genotype and “silent” HBV coinfection: two main risk factors for a more severe liver disease. J Med Virol. 2001;64:350–5.

    Article  PubMed  CAS  Google Scholar 

  11. Torbenson M, Thomas DL. Occult hepatitis B. Lancet Infect Dis. 2002;2:479–86.

    Article  PubMed  Google Scholar 

  12. Paterlini P, Gerken G, Nakajima E, Terre S, D’Errico A, Grigioni W, et al. Polymerase chain reaction to detect hepatitis B virus DNA and RNA sequences in primary liver cancers from patients negative for hepatitis B surface antigen. N Engl J Med. 1990;323:80–5.

    PubMed  CAS  Google Scholar 

  13. Donato F, Gelatti U, Limina RM, Fattovich G. Southern Europe as an example of interaction between various environmental factors: a systematic review of the epidemiologic evidence. Oncogene. 2006;25:3756–70.

    Article  PubMed  CAS  Google Scholar 

  14. Huo TI, Wu JC, Lee PC, Chau GY, Lui WY, Tsay SH, et al. Sero-clearance of hepatitis B surface antigen in chronic carriers does not necessarily imply a good prognosis. Hepatology. 1998;28:231–6.

    Article  PubMed  CAS  Google Scholar 

  15. Ikeda K, Marusawa H, Osaki Y, Nakamura T, Kitajima N, Yamashita Y, et al. Antibody to hepatitis B core antigen and risk for hepatitis C-related hepatocellular carcinoma: a prospective study. Ann Intern Med. 2007;146:649–56.

    PubMed  Google Scholar 

  16. Mulrooney-Cousins PM, Michalak TI. Persistent occult hepatitis B virus infection: experimental findings and clinical implications. World J Gastroenterol. 2007;13:5682–6.

    PubMed  Google Scholar 

  17. Jilg W, Sieger E, Zachoval R, Schatzl H. Individuals with antibodies against hepatitis B core antigen as the only serological marker for hepatitis B infection: high percentage of carriers of hepatitis B and C virus. J Hepatol. 1995;23:14–20.

    Article  PubMed  CAS  Google Scholar 

  18. Weber B, Berger A. Molecular detection of hepatitis B virus: recent development. J Lab Med. 2005;29:33–43.

    CAS  Google Scholar 

  19. Abdel-Wahab MF, Esmat G, Millad M, Abdel-Razek S, Strickland GT. Characteristic sonographic pattern of schistosomal hepatic fibrosis. Am J trop Med Hyg. 1989;40:72–6.

    PubMed  CAS  Google Scholar 

  20. Chemin I, Zoulim F, Merle P, Arkhis A, Chivallier M, Kay A, et al. High incidence of hepatitis B infections among chronic hepatitis cases of unknown aetiology. J Hepatol. 2001;34:447–54.

    Article  PubMed  CAS  Google Scholar 

  21. Brechot C. Pathogenesis of hepatitis B virus related hepatocellular carcinoma: old and new paradigms. Gastroenterology. 2004;127:S56–61.

    Article  PubMed  CAS  Google Scholar 

  22. Raimondo G, Pollicino T, Cacciola I, Squadrito G. Occult hepatitis B virus infection. J Hepatol. 2007;46:160–70.

    Article  PubMed  Google Scholar 

  23. Sheu JC, Huang GT, Shin LN, Lee WC, Chou HC, Wang JT, et al. Hepatitis C and B viruses in hepatitis B surface antigen-negative hepatocellular carcinoma. Gastroenterology. 1992;103:1322–7.

    PubMed  CAS  Google Scholar 

  24. Brechot C, Minami M, De Mitri S, Paterlini P. Hepatitis B and C viruses in hepatitis B surface antigen negative hepatocellular carcinoma patients. Princess Takamatsu Symp. 1995;25:199–209.

    PubMed  CAS  Google Scholar 

  25. Koike K. Co-infection of HBV with HCV and a possible role of HBV DNA in hepatocarcinogenesis. Nippon Rinsho. 1999;57:213–9.

    PubMed  CAS  Google Scholar 

  26. Tamori A, Nishiguchi S, Kubo S, Enomoto M, Koh N, Takeda T, et al. Sequencing of human-viral DNA junctions in hepatocellular carcinoma from patients with HCV and occult HBV infection. J Med Virol. 2003;69:475–81.

    Article  PubMed  CAS  Google Scholar 

  27. Mrani S, Chemin I, Menouar K, Guillaud O, Pradat P, Borghi G, et al. Occult HBV infection may represent a major risk factor of non-response to antiviral therapy of chronic hepatitis C. J Med Virol. 2007;79:1075–81.

    Article  PubMed  CAS  Google Scholar 

  28. El-Zayadi AR, Ibrahim EH, Badran HM, Saeid A, Moneib NA, Shemis MA, et al. Anti-HBc screening in Egyptian blood donors reduces the risk of hepatitis B virus transmission. Transfus Med. 2008;18:55–61.

    Article  PubMed  Google Scholar 

  29. El-Sherif A, Abou-Shady M, Al-Hiatmy M, Al-Bahrawy A, Motawea E. Screening for hepatitis B virus infection in Egyptian blood donors negative for hepatitis B surface antigen. Hepatol Int. 2007;1:469–70.

    Article  PubMed  Google Scholar 

  30. Raimondo G, Navarra G, Mondello S, Costantino L, Colloredo G, Cucinotta E, et al. Occult hepatitis B virus in liver tissue of individuals without hepatic disease. J Hepatol. 2008;48:743–6.

    Article  PubMed  Google Scholar 

  31. Marusawa H, Uemoto S, Hijikata M, Ueda Y, Tanaka K, Shimotohno K, et al. Latent hepatitis B virus infection in healthy individual with antibody to hepatitis B core antigen. Hepatology. 2000;31:488–95.

    Article  PubMed  CAS  Google Scholar 

  32. Okada S, Sato T, Okusaka T, Ishii H, Ikeda M, Nakasuka H, et al. Past exposure to hepatitis B virus as a risk factor for hepatocellular carcinoma in patients with chronic liver disease. Br J Cancer. 1998;77:2028–31.

    PubMed  CAS  Google Scholar 

  33. Imazeki F, Yokosuka O, Fukai K, Hiraide A, Saisho H. Significance of prior hepatitis B virus infection in the development of hepatocellular carcinoma in patients with chronic hepatitis C. Dig Dis Sci. 2003;48:1786–92.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine, Al-Azhar University, Cairo, Egypt

    Assem El-Sherif, Mohamed Abou-Shady, Hany Abou-Zeid, Ahmed Elwassief & Ashraf Elbahrawy

  2. Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Ashraf Elbahrawy, Yoshihide Ueda & Tsutomu Chiba

  3. Department of Clinical Pathology, Al-Azhar University, Cairo, Egypt

    Abdel-Moneim Hosney

Authors
  1. Assem El-Sherif
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  2. Mohamed Abou-Shady
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  3. Hany Abou-Zeid
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  4. Ahmed Elwassief
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  5. Ashraf Elbahrawy
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  8. Abdel-Moneim Hosney
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Correspondence to Ashraf Elbahrawy.

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El-Sherif, A., Abou-Shady, M., Abou-Zeid, H. et al. Antibody to hepatitis B core antigen as a screening test for occult hepatitis B virus infection in Egyptian chronic hepatitis C patients. J Gastroenterol 44, 359–364 (2009). https://doi.org/10.1007/s00535-009-0020-3

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  • DOI: https://doi.org/10.1007/s00535-009-0020-3

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