What is the clinical impact of occult HBV infections and anti-HBc positivity in patients with chronic hepatitis C?

Cakal B., Cavus B., Atasoy A., Poda M., Bulakci M., Gulluoglu M., ...More

Microbiology and immunology, vol.66, no.8, pp.386-393, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 66 Issue: 8
  • Publication Date: 2022
  • Doi Number: 10.1111/1348-0421.13012
  • Journal Name: Microbiology and immunology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED)
  • Page Numbers: pp.386-393
  • Keywords: hepatitis B core antibody, chronic hepatitis C, liver biopsy, nested PCR, occult hepatitis B infection, B-VIRUS INFECTION, HEPATOCELLULAR-CARCINOMA, RISK, REACTIVATION, COINFECTION, DISEASE
  • Istanbul University Affiliated: Yes


Occult hepatitis B infection (OBI) is defined by the persistence of the hepatitis B virus (HBV) genome in the liver of individuals testing negative for hepatitis B surface antigen (HBsAg). Hepatitis B core antibody (anti-HBc) is the serological marker that indicates HBV exposure. The impact of anti-HBc and OBI on patients with chronic hepatitis C remains unclear. The aim of the present study was to determine the prevalence of anti-HBc and OBI and to evaluate their impact on the clinical and pathological outcomes of patients with chronic hepatitis C. The study included 59 HBsAg-negative chronic hepatitis C patients who underwent a liver parenchymal biopsy. The presence of HBV DNA was investigated using an in-house nested PCR method. OBI was detected in 16 (27.1%) of the 59 cases and also in 10 (62.5%) of 22 (37.3%) anti-HBc-positive patients. None of the patients had positive serum HBV DNA. OBI was associated with the presence of anti-HBV antibodies (P < 0.05). There was also an association between anti-HBc positivity and the activity grades and fibrosis stages of the liver and also a prevalence of liver steatosis (P < 0.05). Positive anti-HBc results may predict OBI and may also be associated with the progression of liver injury in HBsAg-negative patients with chronic hepatitis C. Therefore, it is suggested that patients with chronic hepatitis C should be screened for anti-HBc positivity, and anti-HBc-positive patients should be carefully evaluated for disease progression.