Evaluation of Occult Hepatitis B Infection in Individuals with Chronic Hepatitis C Before Treatment with Oral Direct-Acting Antivirals

Nathalia Alves Araujo de Almeida, Jose Junior F de Barros, Catarina Goes de Santana, Natalia Spitz, Leticia Bomfim Campos, Marcia Amendola Pires, Carlos Eduardo Brandao Mello, Vanessa Salete de Paula
2019 Hepatitis Monthly  
Occult hepatitis B virus infection (OBI) is one of the most challenging entities in the field of viral hepatitis. The virological and clinical relevance of OBI in patients treated with novel direct-acting antivirals (DAA) for hepatitis C virus (HCV) infections is currently a topic of hot debate. In cases where hepatitis B surface antigen (HBsAg) is not detected, DAA treatment is often initiated without examining for the presence of hepatitis B virus (HBV) DNA. In this study, the incidence of
more » ... the incidence of OBI was investigated in 114 HCV patients prior to application of DAAs who did not respond to pegylated interferon and ribavirin (PEG-INF and RBV) treatment. Serum samples were screened for HBV serological markers (antibody to hepatitis B core antigen [anti-HBc] and HBsAg). Samples positive for anti-HBc without HBsAg were further examined via real-time PCR (qPCR), nested PCR and S-gene mutational analyses. Overall, anti-HBc was detected in 37.7% chronic HCV patients and 2.6% had OBI with a baseline HBV DNA viral load < 2000 IU/mL before DAA therapy. One patient was identified as HBV genotype A1 without mutations in surface protein. Our collective data highlight the importance of clinicians being aware of potential anti-HBc positivity in patients with hepatitis C and the issues surrounding OBI screening before initiation of treatment with novel DAAs.
doi:10.5812/hepatmon.92317 fatcat:czugo4jbunbzze4ohuceieymcq