Role of occult hepatitis B virus in chronic hepatitis C patients with flare of liver enzymes

European Journal of Internal Medicine
Volume 22, Issue 2 , Pages 187-190, April 2011

Heba S. Selim, Hadia A. Abou-Donia, Hossam A. Taha, Gasser I. El Azab, Ahmed F. Bakry

Received 16 August 2010; received in revised form 28 October 2010; accepted 1 December 2010. published online 18 January 2011

Abstract

Background
Occult HBV infection is defined by detection of HBV DNA in the serum or liver tissue of patients who test negative for HBsAg. The prevalence of occult HBV is higher in hepatitis C virus (HCV) positive patients than HCV negative patients and may have an impact on their clinical outcome. In this study, we evaluated the role of occult hepatitis B virus infection in chronic hepatitis C patients with ALT flare.

Methods
Sixty HBsAg negative patients with chronic hepatitis C virus infection were included. Patients were divided into 2 groups according to their ALT level: 30 patients with normal or slightly high ALT and 30 patients with ALT flare (≥5 times normal values). Patients in both groups were examined for the detection of anti-HBs, anti-HBc IgM, and anti-HBc IgG. HBV DNA was detected using semi-nested PCR technique.

Results
In patients with normal or slightly high ALT, HBV DNA was detected in 4 (13.3%) patients, while in those with ALT flare, HBV DNA was detected in 19 (63.3%) patients (p<0.001). No association was found between the presence of HBV DNA and various serology markers of HBV infection.

Conclusion
Presence of occult hepatitis B, with its added deleterious effect, must always be considered in chronic hepatitis C patients especially those with flare in liver enzymes; HBsAg should not be used alone for the diagnosis of HBV infection.

Keywords: Hepatitis C, Flare of liver enzyme, Elevated aminotransferases, Occult hepatitis B

Source