Conference paper

Publication year: 2010

Pages: 116-125

Journal: Digestive Diseases

Volume number: 28

Issue number: 1

ISSN: 0257-2753

eISSN: 1421-9875

DOI Link: https://doi.org/10.1159/000282074

Conference: Falk Workshop on Immunology and Liver Disease/Falk Symposium 171 on Liver and Metabolic Syndrome

Publisher: Karger Publishers

Abstract: 
The Taormina Consensus Conference defined 'occult hepatitis B virus (HBV) infection' (OBI) as the 'presence of HBV DNA in the liver of individuals testing HBsAg-negative with currently available assays'. Most occult is the so-called 'window period' after exposure before HBV DNA appears in the blood. We identified two blood donors whose donations tested HBsAg-and HBV DNA-negative, but transmitted HBV. Both subsequently developed HBsAg and acute hepatitis. However, such cases are not considered as true OBI. A true transient OBI remains HBsAg-negative during the entire course. One case of acute OBI showed a peak viremia of 15,000 IU/ml HBV DNA and sub-borderline HBsAg, suggesting a ratio of virions to subviral particles of 1:10, whereas 'normal' cases show at peak viremia a ratio of 1:3,000. Blood donors with OBI may transmit HBV. We studied 5 blood donors with OBI and 55 of their recipients. In 22 recipients, transmission was probable, but they remained healthy. However, in 3 recipients, who were immunosuppressed at the time of transfusion, fatal fulminant hepatitis B developed. The majority of anti-HBc-positive healthy individuals have HBV DNA in the liver which may start replication under severe immunosuppression. Nine such cases are described here. OBI or reactivated HBV infections often lead to selection of HBsAg escape mutations as we could show in 11 of 14 cases. Infection of vaccinated individuals favors development of OBI as we observed in 6 blood donors. HB vaccination may solve the problem of overt HBV infection but may favor OBI. Copyright (C) 2010 S. Karger AG, Basel

Harvard Citation style: Gerlich, W., Bremer, C., Saniewski, M., Schuettler, C., Wend, U., Willems, W., et al. (2010) Occult Hepatitis B Virus Infection: Detection and Significance, Digestive Diseases, 28(1), pp. 116-125. https://doi.org/10.1159/000282074

APA Citation style: Gerlich, W., Bremer, C., Saniewski, M., Schuettler, C., Wend, U., Willems, W., & Glebe, D. (2010). Occult Hepatitis B Virus Infection: Detection and Significance. Digestive Diseases. 28(1), 116-125. https://doi.org/10.1159/000282074