Occult Hepatitis B Virus Infection Rate And Clinical Characteristics Analysis Among HBsAg Negative Accompany With Anti-HBc Positive Group

ObjectiveTo investigate Occult hepatitis B virus infection rate and clinical features among people with HBV serum markers as HBsAg negative accompany Anti-HBc positive and explore possible relations between OHBVI and Anti-HBc positive,increase the awareness to Occult hepatitis B virus infection.MethodsCollected blood serum samples and correlative clinical data of 692 patients who did physical check-up between October 2014 to July 2015 in clinic of Jinan Lazaret Hospital of Shandong University.Designed 6 primers specifically for S,C,P section in HBV genome and using Nested polymerase chain reaction (Nested PCR) method to test these blood serum samples.Observe prevalence rate of Occult hepatitis B virus infection (OHBVI) in this kind of crowd and clinical characteristics were retrospectively analyzed.ResultsBy means of Nested polymerase chain reaction we had detected 41 cases with occult hepatitis B virus infection.The rate to occult hepatitis B virus infection in all these 692 cases of HBsAg negative accompany with Anti-HBc positive was 5.92%,serum markers showed independent Anti-HBc positive cases with OHBVI counted to 4 cases,rate to HBV positive was 5.80%(4/69),OHBVI had been detected in serum markers as Anti-HBc positive accompany with Anti-HBs and Anti-HBe positive cases counted to 10 cases,the rate reached to 2.94%(10/340),serum markers showed Anti-HBc positive accompany with Anti-HBe positive with OHBVI counted to 13 cases,the rate reached to 9.35%(13/139) and Anti-HBc accompany with Anti-HBs positive with OHBVI counted to 14 cases,the rate reached to 9.72% (14/144).Among this HBV positive cases,all primers of section S,C,P had been amplified by Nested polymerase chain reaction (Nested PCR) was performed on 18 samples,amplification of both section C and P was performed on 19 samples,amplification of section S and C was performed on 2 samples and amplification of section S and P was performed on 2 samples.In all these occult hepatitis B virus infectors,the amplification efficiency of primer of section S is 53.66% (22/41),the amplification efficiency of primer of section C is 95.12%(39/41) and amplification efficiency of primer of section P is also 95.12%(39/41).There were 3 cases with abnormal transaminase among these occult hepatitis B virus infection samples, all of them showed heightened Alanine aminotransferase (neither of them combined with abnormal aspartate transaminase,direct/indirect bilirubin,alpha fetoprotein,albumin,alkaline phosphatase,gumatyl transpeptidase).In all these occult hepatitis B virus infectors,male patients counted up to 30 cases and relevant positive rate reached to 7.56%(30/397),female patients counted up to 11 cases and relevant positive rate reached to 3.73%(11/295). Occult hepatitis B virus infection in the age group of 35 and less than 35 years old counted up to 13 patients,relevant positive rate reached to 5.51%(13/236), in the age group of 36 to 50 years old the number of infectors counted up to 9 patients,relevant positive rate reached to 3.46% (9/260),among age group of over than 50 years old people the occult hepatitis B virus infectors counted up to 19 patients,relevant positive rate reached to 9.69% (19/169)ConclusionPeople with serum markers showed HBsAg negative accompany with Anti-HBc positive is at risk for occult hepatitis B virus infection and those infectors may not show obvious clinical manifestation or abnormal transaminase.Among this 692 cases there were 41 cases had been detected with occult hepatitis B virus infection,the rate reached to 5.92%,different to other relevant reports between China and world-wide.5.92% is higher to Occult hepatitis B virus infection rate in community public of Shandong Province and volunteer blood donor with anti-HBc positive in Yiwu.The possible reason could be the otherness between researches’ incept standards or different interlocal prevalence rate of HBV.In consideration of the prevalence discrepancy of HBV in distinct area and we didn’t do the detection of HBV infection in liver tissue,this could cause the condition that the occult hepatitis B virus infection rate in this research is lower to some other studies. Unlike other reports we have detected that patients with serum markers showed Anti-HBc accompany with Anti-HBs or Anti-HBe positive have more proportion than independent Anti-HBc positive suffered from Occult hepatitis B virus infection,there could be further research such as genome sequencing to discover the possible mechanism.Male with higher opportunity suffered from OHBVI than female and so did the age group of more than 50 years old,these clinical features should arouse the doctor’s attention for this kind of patients.