Article: Prevalence of occult hepatitis B infection in a highly endemic area for chronic hepatitis B: A study of a large blood donor population

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Publisher Website: 10.1136/gut.2010.209148
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PMID: 20675695
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Title	Prevalence of occult hepatitis B infection in a highly endemic area for chronic hepatitis B: A study of a large blood donor population
Authors	Yuen, MF2 Lee, CK1 Wong, DKH2 Fung, J2 Hung, I2 Hsu, A2 But, DYK2 Cheung, TK2 Chan, P2 Yuen, JCH2 Fung, FKC2 Seto, WK2 Lin, CK1 Lai, CL2
Issue Date	2010
Publisher	BMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/
Citation	Gut, 2010, v. 59 n. 10, p. 1389-1393 [How to Cite?] DOI: http://dx.doi.org/10.1136/gut.2010.209148
Abstract	Background and aims: The aim of the present study was to determine the population prevalence of occult hepatitis B (OHB) infection and its clinical profile in a highly endemic area of chronic hepatitis B virus disease. Methods: OHB was first identified by individual sample testing for hepatitis B surface antigen (HBsAg) followed by nucleic acid testing (NAT) and vice versa for 3044 (cohort 1, stored sera from donation within 1 year) and 9990 (cohort 2, prospective study) blood donors, respectively. OHB was confirmed meticulously by ≥2 out of 3 tests with detectable hepatitis B virus (HBV) DNA using a sensitive standardised assay. Detailed serology and viral load in the serum and liver were studied. Results: The prevalence of OHB was 0.13% (4/3044) and 0.11% (11/9967) for cohort 1 and 2, respectively. In cohort 2, 10 out of 11 OHB samples were positive for anti-HBc (hepatitis B core antigen) antibody (all were immunoglobulin G). Seven had detectable anti-HBs. The serum HBV DNA levels were extremely low (highest 14.1 IU/ml). Of the six donors who underwent liver biopsies, all had normal liver biochemistry, extremely low liver HBV DNA (highest 6.21 copies/cell) and nearly normal liver histology. For those with viral sequence generation, none had the common HBsAg mutant G145R. Conclusions: The prevalence of OHB in a highly endemic area of chronic HBV was very low, thus implying a low impact on transfusion services. To implement universal screening, the high cost of NAT should be taken into account. OHB blood donors had very low HBV replication, and normal liver biochemistry and histology, conferring a favourable prognosis.
ISSN	0017-5749 2011 Impact Factor: 10.111 2011 SCImago Journal Rankings: 0.883
DOI	http://dx.doi.org/10.1136/gut.2010.209148
ISI Accession Number ID	WOS:000282661300017
References	References in Scopus

DC Field	Value
dc.contributor.author	Yuen, MF
dc.contributor.author	Lee, CK
dc.contributor.author	Wong, DKH
dc.contributor.author	Fung, J
dc.contributor.author	Hung, I
dc.contributor.author	Hsu, A
dc.contributor.author	But, DYK
dc.contributor.author	Cheung, TK
dc.contributor.author	Chan, P
dc.contributor.author	Yuen, JCH
dc.contributor.author	Fung, FKC
dc.contributor.author	Seto, WK
dc.contributor.author	Lin, CK
dc.contributor.author	Lai, CL
dc.date.accessioned	2010-10-31T11:10:35Z
dc.date.available	2010-10-31T11:10:35Z
dc.date.issued	2010
dc.description.abstract	Background and aims: The aim of the present study was to determine the population prevalence of occult hepatitis B (OHB) infection and its clinical profile in a highly endemic area of chronic hepatitis B virus disease. Methods: OHB was first identified by individual sample testing for hepatitis B surface antigen (HBsAg) followed by nucleic acid testing (NAT) and vice versa for 3044 (cohort 1, stored sera from donation within 1 year) and 9990 (cohort 2, prospective study) blood donors, respectively. OHB was confirmed meticulously by ≥2 out of 3 tests with detectable hepatitis B virus (HBV) DNA using a sensitive standardised assay. Detailed serology and viral load in the serum and liver were studied. Results: The prevalence of OHB was 0.13% (4/3044) and 0.11% (11/9967) for cohort 1 and 2, respectively. In cohort 2, 10 out of 11 OHB samples were positive for anti-HBc (hepatitis B core antigen) antibody (all were immunoglobulin G). Seven had detectable anti-HBs. The serum HBV DNA levels were extremely low (highest 14.1 IU/ml). Of the six donors who underwent liver biopsies, all had normal liver biochemistry, extremely low liver HBV DNA (highest 6.21 copies/cell) and nearly normal liver histology. For those with viral sequence generation, none had the common HBsAg mutant G145R. Conclusions: The prevalence of OHB in a highly endemic area of chronic HBV was very low, thus implying a low impact on transfusion services. To implement universal screening, the high cost of NAT should be taken into account. OHB blood donors had very low HBV replication, and normal liver biochemistry and histology, conferring a favourable prognosis.
dc.description.nature	published_or_final_version
dc.identifier.citation	Gut, 2010, v. 59 n. 10, p. 1389-1393 [How to Cite?] DOI: http://dx.doi.org/10.1136/gut.2010.209148
dc.identifier.doi	http://dx.doi.org/10.1136/gut.2010.209148
dc.identifier.epage	1393
dc.identifier.hkuros	179939
dc.identifier.hkuros	213682
dc.identifier.isi	WOS:000282661300017
dc.identifier.issn	0017-5749 2011 Impact Factor: 10.111 2011 SCImago Journal Rankings: 0.883
dc.identifier.issue	10
dc.identifier.openurl
dc.identifier.pmid	20675695
dc.identifier.scopus	eid_2-s2.0-77957190181
dc.identifier.spage	1389
dc.identifier.uri	http://hdl.handle.net/10722/125086
dc.identifier.volume	59
dc.language	eng
dc.publisher	BMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/
dc.publisher.place	United Kingdom
dc.relation.ispartof	Gut
dc.relation.references	References in Scopus
dc.rights	Creative Commons: Attribution 3.0 Hong Kong License
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Blood Donors - statistics and numerical data
dc.subject.mesh	Carrier State - epidemiology - pathology
dc.subject.mesh	Hepatitis B, Chronic - epidemiology - pathology
dc.title	Prevalence of occult hepatitis B infection in a highly endemic area for chronic hepatitis B: A study of a large blood donor population
dc.type	Article

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Author Affiliations

Hong Kong Hospital Authority
The University of Hong Kong