Prevalence Of Occult Hepatitis Research Articles

Prevalence of occult hepatitis C virus infection (OCI) among hemodialysis patients; a cross–sectional study from Lorestan Province, Western Iran

Prevalence of occult hepatitis C virus infection (OCI) among hemodialysis patients; a cross–sectional study from Lorestan Province, Western Iran

Prevalence of occult hepatitis B infection among treatment-naive persons living with HIV in Ghana.

Hepatitis B virus (HBV) constitutes a significant global health challenge, with more than 2 billion people infected globally and almost 291 million chronic cases. In Africa, coinfection of HBV with Human Immunodeficiency Virus (HIV) is high, yet the condition remains overlooked in many countries. While antiretroviral therapy (ART) has improved HIV survival, viral hepatitis continues to contribute to morbidity and mortality. Occult Hepatitis B infection (OBI), characterized by a low-level of HBV DNA in individuals with negative hepatitis B surface antigen (HBsAg), is an emerging concern among HIV seropositive individuals due to the risk of HBV reactivation and associated complications, especially hepatocellular carcinoma (HCC). Ghana has an estimated HBV/HIV coinfection prevalence of 13.6% making it important to also determine potential cases of OBI. This study aims to assess OBI prevalence in persons living with HIV (PLHIV). A cross-sectional study was conducted in five health facilities in the Cape Coast Metropolis. HBV-related serological markers were determined among 116 PLHIV using the Enzyme-Linked Immunosorbent Assay (ELISA) method. HBV DNA was extracted from 30 participants found to be HBsAg negative but positive for hepatitis B core antibody (HBcAb+). Nested PCR was employed in detecting HBV DNA and HBV viral load was performed using qPCR. The median age of the participants was 37 years (IQR 22-65). Serologically, 7.8% (n = 9, 95% CI: 3.5-22.7), 12.1% (n = 14), and 25.9% (n = 30) tested positive for solely HBsAg, HBsAb, and HBcAb respectively. OBI prevalence among HBsAg-/HBcAb+ participants was 16.7% (n = 5, 95% CI: 6.5-23.7) with a median HBV DNA level of 139.2 IU/ml (IQR, 96.7-142.0). The prevalence of OBI among HIV-positive participants in the Cape Coast Metropolis highlights the need to consider screening for HBV among HIV patients using nucleic acid amplification tests. This can inform medical management and reduce the risk of liver complications, including HCC.

Anti-HBc antibodies and occult hepatitis B infection (OBI) among blood donors in Lomé, Togo

Aims: Among the progressive forms of hepatitis B virus (HBV) infections, the HBs antigen (HBsAg) remains undetectable in 25% of cases. There is also a form of HBV infection called occult HBV infection (OBI) characterized by the presence of viral DNA in the blood and tissues with no detectable levels of HBsAg associated with or without anti-HBc Ab, or anti-HBs Ab out of the pre-seroconversion period, which constitutes an infectious risk in blood transfusion. Methods: To determine the prevalence of anti-HBc Abs and the HBV DNA in the blood of donors recruited at the blood transfusion center (CNTS) of Lomé. This is a cross-sectional study including 967 blood donations which were seronegative to HBs antigen during the biological qualification of the donation (BQD) from July 28 to August 19, 2022. The detection of total anti-HBc Abs (IgM and IgG) was performed by BIORAD enzyme-linked immunosorbent assay (ELISA) method; the viral load measurement was carried out according to the polymerase chain reaction method by amplification of COBAS AmpliPrep/TaqMan 4800 (Roche diagnostics). Data processing and analysis were performed using EXCEL 2013 software and SPSS software. Concerning the ethical aspect, we have obtained written consent from the donors and the agreement of the bioethics committee for health research No. 052/2022/CBRS. Results: The prevalence of anti-HBc Abs was 33.82% (CI: 30.83–36.80). Viral DNA was detected in 10 cases. The prevalence of occult hepatitis B was 3.05% (10/327) in blood donors carrying anti-HBc antibodies, and 1.03% (10/967) in the blood donors population that does not carry HBsAg. Conclusion: The presence of occult hepatitis B within the population of blood donors at the blood transfusion center of Lomé constitutes a real threat to transfusion safety. The association of the viral DNA detection by PCR to the serological tests that are currently carried out during the biological qualification of the donations could be a better approach to reduce the risk of transmission of HBV by blood transfusion at the CNTS of Lomé.

Prevalence of occult hepatitis B in southeast Asia: The first systematic review and meta-analysis

Prevalence of occult hepatitis B in southeast Asia: The first systematic review and meta-analysis

The prevalence of occult hepatitis B infection among the blood donors in a donation center in Beijing

Occult HBV infection (OBI) remains a potential threat for blood safety. The prevalence of OBI was investigated in a blood donation center of Chinese PLA General Hospital to improve HBV blood safety. 229446 samples from blood donors were screened by two different enzyme-linked immunosorbent assay (ELISA) kits. 78 samples were HBV DNA positive among 212134 ELISA nonreactive donor samples. The prevalence of OBI was 0.04% (76/212134). Ten samples of OBI were permitted by the donors’ content for further research, and all of these were below 200IU/mL, and six of these were below 20IU/mL(6/10,60%). Genotype B and genotype C was 20% (2/10) and 80% (8/10), respectively. 16 amino acid mutations were detected in the S region of OBI, included three mutations in MHR region of S. The prevalence of OBI is rare in this donation center. These mutations we found may contribute to the multifactorial occurrence of OBI.

Differences of Hepatitis B Serological Tests in Cirrhosis and Hepatocellular Carcinoma Patients

Cirrhosis and hepatocellular carcinoma (HCC) are the most common complications of chronic hepatitis B. Hepatitis B Virus (HBV) reactivation occurs in the inactive phase, characterized by reappearance of HBsAg or negative HBsAg. The prevalence of occult hepatitis B infection in cirrhosis and HCC ranges from 20% to 60%. This study aimed to analyze the differences in hepatitis B serological tests in patients with cirrhosis and HCC for diagnosis of acute or chronic hepatitis B. The current research was analytical and descriptive with a cross-sectional study design. This study involved 177 patients, including 50 cirrhosis patients and 127 HCC patients. Hepatitis B serological tests (HBsAg, HBeAg, anti-HBe, total anti-HBc) were analyzed using VIDAS instruments by the Enzyme-Linked Fluorescent Immunoassay (ELFA) method. Hepatitis B serological test results were grouped based on the interpretation of serological test results. The data were processed with the statistical test Kolmogorov-Smirnov test, independent T-test, and Chi-Square, and results with p<0.05 were reported as significant. This study found that most males suffer from cirrhosis and HCC due to chronic HBV infection, with a mean age of 57. Chronic hepatitis was most common in patients with cirrhosis and HCC (71.2%). There was no significant difference in the interpretation of the hepatitis B serological test between patients with cirrhosis and HCC, with a p-value of 0.230 (p > 0.05). There was no significant difference in interpreting the hepatitis B serological test between cirrhosis and HCC. Both reactive HBsAg and non-reactive HBsAg can be obtained in cirrhosis and HCC.

Effect of obligatory Hepatitis B vaccination program on the prevalence of occult hepatitis B among pregnant women in Egypt: A cross sectional study

Hepatitis B virus (HBV) infection is a global health problem. HBV is of intermediate endemicity in Egypt. “Occult” HBV (OBI) indicates replication of HBV-DNA in the liver of individuals with negative serum HBsAg. This study aimed to determine the prevalence of OBI among pregnant women in Egypt and to compare this prevalence among HBV vaccinated and unvaccinated women (received obligatory vaccination). This cross-section study included 474 pregnant women in the third trimester divided in two groups. Group I: (n=247) assumed received obligatory hepatitis B vaccination and group II: (n=227), did not receive HBV vaccination. Study participants were screened for HBsAg, anti HBs, anti HBc total, anti HBc IgM, HBeAg, anti HBe, HCV Ab, and HIV Ab by immunoassays and HBV-DNA by Real-Time PCR. Anti HBs was detected in 65 (13.7%) of pregnant women, 36 (14.6%) in the vaccinated group and 29 (12.8%) in the unvaccinated group. The anti HBs levels were significantly higher in the unvaccinated group. HBc Ab showed positive results in 6 cases (2.4%) in the vaccinated group, and 14 cases (6.2%) in unvaccinated group. HBcAb and/or HBsAb were detected in 72 (15.1%) of pregnant women, 39 (15.8%) in the vaccinated group and 33 (14.5%) in the unvaccinated group. HBV-DNA was detected only in one vaccinated pregnant woman. HB vaccination program in Egypt, since 1992 affected the frequency of OBI in pregnant women (p=0.04). In conclusion, HBV infection may persist lifelong in the hepatocytes even when viral functions are suppressed, HBsAb and anti-HBc-positive individuals are present. The levels of HBsAb were higher in unvaccinated pregnant women compared to vaccinated pregnant women. HBV infection in OBI pregnant women may not transmit to the new-born.

Prevalence of occult hepatitis B virus infection and characterisation of hepatitis B surface antigen mutants among adults in western Croatia

Introduction and ObjectivesOccult hepatitis B virus (HBV) infection (OBI) is characterised by low levels of hepatitis B virus (HBV) DNA in the blood/liver of patients with negative hepatitis B surface antigen (HBsAg). This study aimed to determine the OBI prevalence and virological characteristics (viral genotypes and HBsAg mutants) in patients with an “anti-HBc only” serological profile. Materials and MethodsA total of 24 900 serum samples were routinely screened for hepatitis B markers over a five-year period. All anti-HBc-positive/HBsAg-negative/anti-HBs-negative sera were selected and analysed for the presence of HBV DNA. Mutational analyses of the HBs gene and polymerase gene sequences were performed. Results1749 (7.02%) sera were anti-HBc positive, and 113 (0.45%) sera had an “anti-HBc only” serological profile (HBsAg/anti-HBs negative). HBV DNA was detected in 12/113 (10.61%) “anti-HBc only” positive sera, representing 0.048% of all routinely tested samples. Due to extremely low viremia, HBV genome was successfully sequenced in only two sera where subgenotype D3 was confirmed. Mutational analyses of the S gene revealed multiple missense mutations. In addition to the M133I, Y134F, and G145R mutations, already associated with diagnostic escape, we also found nine novel OBI-related S-gene mutations - S136Y, F158L, K160N, E164G, S167L, A168V, L175S, S210I and F212C. ConclusionsWe detected multiple known and novel S gene mutations in 2/12 (16.6%) OBI cases, nevertheless, further studies are required to determine their role in the pathogenesis of OBI. Understanding the frequencies of clinically relevant HBV mutations may contribute to improvement of diagnostic protocols.

Prevalence of occult hepatitis B virus infection among chronic hemodialysis adult patients in Minia governorate, Egypt

Prevalence of occult hepatitis B virus infection among chronic hemodialysis adult patients in Minia governorate, Egypt

Prevalence of occult hepatitis B virus infection among patients receiving haemodialysis in Sana'a city

Occult hepatitis B virus infection (OBI) is a challenging entity. Due to the increase in invasive procedures, blood transfusions, and difficulties in diagnosing OBI, patients are more likely to acquire OBI. This cross-sectional study was conducted to assess the prevalence of OBI by hepatitis B virus (HBV)-DNA detection, the prevalence of HBV infection by total hepatitis B core antibody (HBcAb) detection, and the potential risk factors for HBV infection in patients receiving haemodialysis regularly. This study included 80 patients receiving haemodialysis regularly, without acute or chronic HBV infection. They were selected from the dialysis units in Sana'a city, Yemen from June 2016 to June 2017. Patients who were positive for hepatitis B surface antigen and hepatitis B surface antibody were excluded from this study. Blood samples were taken prior to each haemodialysis session, and serological markers of HBV were included. HBcAb was measured by enzyme-linked immunosorbent assay, and HBV-DNA was measured by polymerase chain reaction. HBV-DNA was detected in four patients (5%) and HBcAb was detected in 38 patients (47.5%). There was a significant association between HBV-DNA and HBcAb in patients receiving haemodialysis regularly. Patients who test positive for HBcAb should undergo additional HBV-DNA testing to allow accurate HBV screening and prevent infection of other patients.

Characterization of occult hepatitis B infection among Iranian liver transplant recipients.

BackgroundThe prevalence of occult hepatitis B infection (OBI) among Iranian liver transplant recipient patients has not been explored yet. The present study aimed to determine the OBI prevalence among Iranian liver transplant recipients.MethodsThis study encompassed 97 patients having undergone liver transplantation due to several clinical backgrounds in the Liver Transplantation Center, Tehran, Iran. After serological evaluation, two different types of PCR methods were applied for amplification of HBV DNA, followed by the direct sequencing of whole hepatitis B virus (HBV) surface genes.ResultsAt the time of admission, none of the patients were positive for HBsAg. However, 24 (25%), 12 (12.3%), and 5 (5.1%) cases were positive for anti‐HBc, hepatitis C virus (HCV), and hepatitis delta virus (HDV) antibodies, respectively. Moreover, two males were positive for OBI (2.1%). Both were positive for anti‐HBc and negative for anti‐HBs, anti‐HCV, and anti‐HDV. HBV‐related cirrhosis was the underlying reason for their liver transplantation. HBsAg sequences revealed no amino acid substitution.ConclusionsThe prevalence of OBI in the Iranian liver transplantation patients was relatively low. Future longitudinal studies with a larger sample size are suggested to explore the significance of this clinical finding, including the reactivation of cryptic HBV DNA, in liver transplant subjects.

Prevalence of occult hepatitis B virus infection in adults: a systematic review and meta-analysis

Despite growing concerns about transmissibility and clinical impact, occult hepatitis B virus (HBV) infection has received little attention in the hepatitis elimination agenda. We aimed to estimate the prevalence of occult HBV infection at a global and regional scale and in specific populations. For this systematic review and meta-analysis, we searched the MEDLINE, Embase, Global Health, and Web of Science databases for articles published in any language between Jan 1, 2010, and Aug 14, 2019. We included original articles and conference abstracts of any study design that reported the proportion of HBsAg-negative adults (aged ≥18 years) who are positive for HBV DNA (ie, people with occult HBV infection). The prevalence of occult HBV infection was pooled, using the DerSimonian-Laird random-effects model, in the general population and specific groups defined by the type of study participants (blood donors; other low-risk populations; high-risk populations; and people with advanced chronic liver disease), and stratified by HBV endemicity in each country. We also assessed the performance of anti-HBc as an alternative biomarker to detect occult HBV infection. The study was registered with PROSPERO, CRD42019115490. 305 of 3962 articles were eligible, allowing a meta-analysis of 140 521 993 individuals tested for HBV DNA. Overall, only two studies evaluated occult HBV infection in the general population, precluding unbiased global and regional estimates of occult HBV infection prevalence. In blood donors, occult HBV infection prevalence mirrored HBV endemicity: 0·06% (95% CI 0·00-0·26) in low-endemicity countries, 0·12% (0·04-0·23) in intermediate-endemicity countries, and 0·98% (0·44-1·72), in high-endemicity countries (p=0·0012). In high-risk groups, occult HBV infection prevalence was substantial, irrespective of endemicity: 5·5% (95% CI 2·9-8·7) in low-endemicity countries, 5·2% (2·5-8·6) in intermediate-endemicity countries, and 12·0% (3·4-24·7) in high-endemicity countries. The pooled sensitivity of anti-HBc to identify occult HBV infection was 77% (95% CI 62-88) and its specificity was 76% (68-83). A substantial proportion of people carry occult HBV infection, especially among high-risk groups across the globe and people living in highly endemic countries. Occult HBV infection should be part of the global viral hepatitis elimination strategy. None.

Prevalence of occult hepatitis B virus infection among the blood donors in Golestan province: cross-sectional study.

Despite the increased sensitivity of screening tests, the HBV can be transmitted during the window period and occult hepatitis B infection. The purpose of this study was to evaluate HBV markers and prevalence of OBI among HBsAg negative blood donors in Golestan province. Anti-HBc (IgM and IgG), anti-HBs and anti-HBe tests on 4313 serum samples (HBsAg negative) were performed by ELISA method. Also, all samples for the presence of HBV-DNA were tested by using NAT methods. SPSS software and chi-square test were used for data analysis. Of the 4313 samples, 384 (8.9%) sera were anti-HBc positive. Also, of 384 anti-HBc positive samples, 302 (78.65%) were anti-HBs positive and 152 (39.6%) were anti-HBe positive. Thirty-nine (0.90%) samples were anti-HBc positive, anti-HBs negative and anti-HBe negative. HBV-DNA was not detected in any of specimens. Based on the results of retesting the isolated anti-HBc samples that after one year recalling, had undetectable HBV-DNA and for the prevention of the decreasing of healthy blood donation (due to false positive anti-HBc) and preservation of the blood supplies; Individual Donor Nucleic Acid Testing (ID-NAT) along with the anti-HBc testing for the improving blood safety is recommended.

Prevalence of occult hepatitis B infection in Diyala province, Iraq

Background: Occult HBV infection (OBI) is the absence of hepatitis surface antigens (HBsAg) that is not apparent during detection by serological tests despite the presence of virus DNA. This study aimed to explore the prevalence of OBI infection among various populations in Diyala province, Iraq. Methods: A prospective cross-sectional study was conducted from 1st January to 30th September, 2021, at Ibn Sina Dialysis Center, Baquba Teaching Hospital, Iraq. Three hundred and sixty participants were equally involved (90 individuals for each) from the dialysis department, the thalassemia department, blood bank donation Centre, and the control group. Study populations were screened for HBV Ag, HBV c IgG, HBV c IgM, abusing the enzyme-linked immunosorbent assay (ELISA) test, and detecting HB core gene. Demographic data of the study group were recorded. Descriptive analysis was done using SPSS Version 25, and the P-value was considered significant wherever it was below 0.05. Results: The positivity rate of serological markers of OBI among the study population was (6.7%) of the participants were HBs Ag positive. Whereas 22 (6.1%) were anti-HBc IgG positive and 3 (0.8%) were anti-HBc IgM positive. The detection rates of the PCR products of 76 participants after amplification using specific primers for (core-gene) have been presented to the gel electrophoresis, which showed none of the 76 participants were positive for the HBc gene. Conclusion: The current study showed a medium percentage of anti-HBc IgG in the serum of the study groups without the presence of HBs Ag, which indicates the presence of a previous infection that was resolved or the occurrence of occult hepatitis B infection. The current study results also showed that the serum of any of the study groups was not positive for the core gene, which confirms the possibility of infection with OBI.

High-Frequency Notable HBV Mutations Identified in Blood Donors With Occult Hepatitis B Infection From Heyuan City of Southern China.

BackgroundAll Chinese blood centers have implemented mini pool (MP) HBV nucleic acid testing (NAT) together with HBsAg ELISA in routine donor screening since 2015. The prevalence of occult hepatitis B virus infection (OBI) in donors from different regions varies, and the molecular characterization of the HBV DNA and clinical outcomes of these OBIs remain largely unexplored.MethodsBlood donations from Heyuan city in Southern China were screened by HBsAg ELISA and HBV MP8 NAT. Donations with HBsAg-/HBV DNA+ were collected for this study. Molecular characterizations of HBV DNAs were further analyzed by various DNA amplification assays including quantitative PCR (qPCR) and nested PCR, amplifying the basic core and pre-core promoter regions (BCP/PC). The HBsAg (S) region from HBV DNA was isolated by high-volume nucleic acid extraction. Notable mutations were identified by comparison to the HBV reference sequences. The clinical outcomes of the donors with OBIs were further followed for nearly 3 years.ResultsSeventy OBIs from 44,592 donations (0.15%) that we identified and reported previously were enrolled for this current study. HBV sequences were obtained from 44/70 OBIs, and genotyping analysis showed that 42/44 (95.2%) OBIs were genotype B, and 2/44 (4.8%) were genotype C. Interestingly, mutation analysis revealed that various mutations including M133L/T, F134L, P142L, V168A, R169H, S174N, L175S, and V177A of HBV DNA affecting HBsAg detection were observed in genotype B OBIs. Two notable mutations, T47K and L53S, were identified in genotype C OBIs. Follow-up studies showed that 3/31 (9.7%) OBIs converted to HBsAg+ as chronic infections while 1/31 (3.2%) HBV DNA was undetectable (classified as recovery) and 27/31 (87.1%) remained as OBIs.ConclusionVarious notable mutations affecting HBsAg detection were observed in blood donors with OBIs in Heyuan city of Southern China. Follow-up studies showed that most OBIs remained as OBIs with fluctuating or low viral loads. Higher sensitive HBV ID NAT is recommended for donor screening to further reduce the transmission risk of OBIs.

THE IMPACT OF OCCULT HEPATITIS B INFECTION ON THE COURSE OF CHRONIC HEPATITIS C TREATMENT WITH DIRECT-ACTING ANTIVIRALS

The prevalence of viral hepatitis B and C in Azerbaijan is 3.2% and 4.3% respectively. The incidence of occult hepatitis B has not been previously studied. The purpose of this study is to assess the prevalence of occult hepatitis B infection among patients with chronic hepatitis C, as well as to assess the impact of occult hepatitis B on the progression of liver disease and to identify the likelihood of viral/clinical reactivation of occult hepatitis B during treatment with direct-acting antiviral drugs. Results. The study included 164 patients with chronic hepatitis C with the absence of overt hepatitis B (HBsAg negative). A specific immunoglobulin to the core antigen of the hepatitis B virus (anti-HBcIgG) was examined and, depending on its serological activity, the patients were divided into 2 groups: 72 anti-HBcIgG-positive and 92 anti-HBcIgG-negative individuals. Hepatitis B Virus DNA was tested in both groups. During the treatment of hepatitis C with direct-acting antiviral drugs, the evidence of viral and clinical reactivation of occult hepatitis B was evaluated. Results. Out of 72 anti-HBc positive patients, 18 (25%) showed detectable viral load. None of the patients had a pre-treatment Hepatitis B Virus DNA level greater than 2000 IU/mL (34-223 IU/mL). Out of 92 anti-HBcIgG negative patients, none had positive Hepatitis B Virus DNA prior to the treatment. In the group of patients with chronic hepatitis C and positive anti-HBcIgG, clinical manifestations and changes in biochemical parameters were more pronounced that in anti-HBcIgG negative group, however, this correlation was not statistically significant. In both groups, there was no 1 log increase in Hepatitis B Virus DNA and ALT during and after the treatment. Conclusions. In Azerbaijan, the presence of anti-HBc IgG was observed in 43% of patients with chronic hepatitis C. In patients who are negative for anti-HBcIgG, 100% had undetectable Hepatitis B Virus DNA. Among those with positive anti-HBcIgG, 25% had low levels of Hepatitis B Virus DNA, which accounted for 10.9% of the total number of patients with chronic hepatitis C. Positive anti-HBcIgG was associated with higher pre-treatment ALT and liver fibrosis score. Treatment with direct-acting antiviral drugs did not cause virological or clinical reactivation of occult hepatitis B in both groups. The presence of OBH did not affect sustained virological response in the treatment of chronic hepatitis C.

Prevalence of Occult Hepatitis C Virus Infection in Egyptian Patients with Lymphoma: A New Vision.

Occult hepatitis C virus infection (OCI) is the absence of HCV RNA in serum and the presence of actively replicating HCV RNA in hepatocytes and peripheral blood mononuclear cells (PBMCs), as evidenced by the presence of antigenomic negative sense single-stranded RNA. This study aimed to determine the prevalence of OCI in Egyptian lymphoma patients and assess changes in biochemical parameters in patients with confirmed OCI. The current study was conducted on 100 apparently healthy subjects as control group and 100 patients with lymphoma as a case group. HCV RNA was extracted and detected in both plasma and PBMCs using qRT-PCR. Total protein, albumin, ALT, AST, and total and direct bilirubin were measured in serum. OCI was detected in 6% of the patient group. OCI patients had lower levels of total protein and serum albumin and higher ALT and AST compared with lymphoma patients without OCI. Our study revealed that six out of 100 patients with lymphoma disorders had occult HCV infection (6%). Therefore, the possibility of this infection should be considered in patients with lymphoma.

Prevalence of occult hepatitis B among HIV-positive individuals in Africa: A systematic review and meta-analysis.

The prevalence of hepatitis B virus among HIV-seropositive individuals is believed to be high, and yet the disease remains neglected in many areas of the continent. Little is known about occult hepatitis in HIV individuals. This review assessed occult hepatitis B infection and its prevalence in the different regions of the African continent. It also determines its prevalence in the HIV population which is endemic in the region. Studies were searched from the Cochrane, google scholar, PubMed/Medline, and African Journals online. Authors included cross-sectional studies, case controls, and cohorts, from 2010 to January 2021, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Participants, Interventions, Comparisons, Outcomes, and Study design frameworks to develop the search strategy. All studies had participants who were HIV-positive, covering different regions of the continent. Risk ratio was used to measure effect size, and Stata 14 software was used for analysis. Eleven studies met the eligibility criteria, with 2567 participants. Overall prevalence of occult hepatitis B was 11.2%. Regional prevalence was 26.5% for the south, 11% for the north, 9.1% for the east, and 8.5% for the western region. Approximately 10% of HIV-seropositive individuals were co-infected with occult hepatitis B virus. Regionally, the prevalence was highest in the southern region and lowest in the west. The prevalence of occult HBV infection was compared between the southern region and the other regions. It was higher in the south compared to the east (risk ratio = 0.87, 95% confidence interval (0.83–0.91)). It was also higher in the south compared to the north (risk ratio = 0.82, 95% confidence interval (0.79–0.85)), and it was also higher in the south compared to the west (risk ratio = 0.85, 95% confidence interval (0.82–0.87)). Public health measures and interventions are required to raise awareness, increase prevention, and reduce spread of the disease. More evidence-based studies need to be carried out.

Prevalence of occult hepatitis C virus infection in beta-thalassemia major patients in Ahvaz, Iran.

Occult hepatitis C virus infection (OCI) is defined by the presence of HCV RNA in peripheral blood mononuclear cells (PBMCs) and liver tissue cells despite the absence of HCV RNA in plasma. Currently, OCI is classified into two types: seropositive OCI (anti-HCV positive and serum HCV RNA negative) and seronegative OCI (anti-HCV and serum HCV RNA negative). Beta-thalassemia is described as a blood disorder that decreases the synthesis of hemoglobin. Repeated blood transfusion is the standard treatment for patients with beta-thalassemia major (BTM), and this increases the risk of exposure to infectious agents. The aim of this study was to investigate the prevalence of OCI among BTM patients. Plasma and PBMCs were collected from 90 BTM patients who were referred to Shafa Hospital in the city of Ahvaz and were screened for HCV antibody using a commercial ELISA kit as the first step. Next, nested RT-PCR was performed on extracts of plasma and PBMCs. HCV RNA from positive PBMCs was sequenced, the sequences were aligned, and a phylogenetic tree was constructed to determine their relationship to reference sequences retrieved from the GenBank database. Seventy-nine out of 90 patients (87.8%) were negative for HCV Ab (seronegative), while 11 patients (12.2%) were seropositive. HCV RNA was found in PBMCs of four patients (66.7%) who were negative for HCV Ab (seronegative) and two patients (33.3%) who were positive for HCV Ab (seropositive). HCV RNA was not detected in plasma samples from these six patients. Six out of 90 BTM patients (6.7%) had OCI. HCV genotyping revealed that all six patients were infected with HCV subtype 3a. We found a high frequency of OCI in BTM patients, which warrants more attention, considering the importance of this infection. Further studies are needed to determine the actual prevalence of OCI in BTM patients in Iran.

Prevalence of occult hepatitis B virus infection among blood donors in Ouagadougou, Burkina Faso

Background: In Burkina Faso, the polymerase chain reaction (PCR) assay is not routinely used in the biological qualification of blood donations and this constitutes a risk factor for the transmission of occult hepatitis B virus (HBV) infection during blood transfusion. The objective of this study is to determine the prevalence of occult B infection (OBI) among blood donors for the purposes of improved blood safety in Burkina Faso.
 Methodology: A descriptive cross-sectional study of 300 HBsAg negative blood donors was conducted in the city of Ouagadougou, Burkina Faso from April to October 2020. Anti-HBc antibody was determined using the BOSON® brand rapid tests. HBV DNA was detected in 75 selected donors by real-time PCR (rt PCR) using the 7500 Fast Real Time PCR assay technique.
 Results: Of the 300 HBsAg negative donors, 208 (69.3%) were males while 92 (30.7%) were females, with average age of 30.18 years. Anti-HBc antibody was detected in 39 cases (13%). Of the 75 donor samples tested by rt PCR, 3 (4%) were positive for HBV DNA (occult B infection); 2 of which were anti-HBc antibody positive (seropositive OBI) while 1 was anti-HBc antibody negative (seronegative OBI).
 Conclusion: Given the prevalence of OBI of 4% in this study and its consequences in blood recipients, it appears necessary that in addition to the classic serological markers of hepatitis B, to test for the presence of HBV DNA among blood donors in order to improve transfusion safety.
 Keywords: Prevalence, Occult B infection; Blood donors, Ouagadougou.
 
 French title: Prévalence de l'infection occulte par le virus de l'hépatite B chez les donneurs de sang à Ouagadougou, Burkina Faso
 Contexte: Au Burkina Faso, la polymérase chain réaction (PCR) n’est pas utilisée lors de la qualification biologique des dons et cela constitue un facteur de risque de transmission de l’Infection Occulte du virus B (VHB) lors des transfusions sanguines. L’objectif de cette étude était de déterminer la prévalence de l’infection occulte B chez les donneurs de sang en vue d’une meilleure sécurité transfusionnelle.
 Méthodologie: Une étude transversale prospective, réalisée d’avril à octobre 2020 dans la ville de Ouagadougou incluant 300 donneurs de sang AgHBs négatif. L’anticorps anti HBc a été déterminé par les tests rapides de marque BOSON®. L’ADN du VHB a été recherché chez 75 donneurs par PCR en temps réel (rt PCR) avec le 7500 Fast Real Time PCR.
 Résultats: Parmi les 300 donneurs AgHBs négatifs, 208 (69,3%) étaient des hommes et 92 (30,7%) des femmes. L’âge moyen était de 30,18 ans. La recherche de l’Ac anti-HBc était positive dans 39 cas (13 %). Parmi les 75 échantillons passés à la rt PCR, 3 (4%) étaient positifs pour l’ADN du VHB. Sur les 3 cas d’ADN VHB positifs, 2 (66,67%) étaient positifs Ac anti HBc et 1 (33,33%) Ac anti HBc négatif.
 Conclusion: Compte tenu de la prévalence de l’infection occulte B et ses conséquences chez les donneurs de sang et chez les receveurs, il devient nécessaire de rechercher, en plus des marqueurs sérologiques classiques de l’hépatite B, l’ADN VHB pour une meilleure sécurité transfusionnelle.
 Mots clés: Prévalence, Infection occulte de l’HBV, Donneurs de sang, Ouagadougou