Occult Hepatitis B Infection in Hepatitis C Patients with Hematological Disorders

Abstract

Background: Occult hepatitis B infection (OBI) is determined by finding hepatitis B virus (HBV) DNA in the liver cells of the patients with negative tests for HBV surface antigen. It is more common in patients with hepatitis C virus (HCV) infection which can be transmitted by blood transfusion and is frequently seen in hemophilia and thalassemia patients. Objectives: The aim of this study was to assess the prevalence of OBI among Iranian patients with hematological disorders (thalassemia, hemophilia and other coagulation factor deficiencies) infected with chronic hepatitis C (CHC). Methods: In this descriptive cross-sectional study, all patients with hematological disorders (thalassemia, hemophilia or other coagulation factor deficiencies) who had simultaneous CHC infection and were referred to the Tehran hepatitis center between 2009 and 2010 were enrolled. Occult hepatitis B infection identification was based on serum HBV-DNA tests. Data analysis was performed with SPSS software. Results: All patients were HBsAg-negative and HCV RNA-positive. Only 145 patients were evaluated for HBV DNA (126 male and 19 female patients). The mean age (SD) was 28.12 (8.6) years. Thirty-five patients had thalassemia, 95 patients had hemophilia, and 15 patients had coagulation factor deficiencies. Serum HBV-DNA was negative for all cases. Conclusions: Based on our results, it seems that there were no cases of OBI among chronic HCV-infected patients with thalassemia and bleeding disorders, particularly hemophilia. However, to improve decisions concerning OBI screening, especially in transfusion centers, and concerning the use of comprehensive screening methods, more original studies with more precise laboratory techniques and larger sample sizes are needed.