Occult HBV infection in Morocco: from chronic hepatitis to hepatocellular carcinoma
Article first published online: 11 MAR 2014
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Volume 34, Issue 6, pages e144–e150, July 2014
How to Cite
Liver Int. 2014: 34: e144–e150
- Issue published online: 17 JUN 2014
- Article first published online: 11 MAR 2014
- Accepted manuscript online: 6 FEB 2014 04:17PM EST
- Manuscript Accepted: 30 JAN 2014
- Manuscript Received: 2 APR 2013
- chronic HCV infection;
- cryptogenic hepatitis;
- hepatitis B virus;
- hepatocellular carcinoma;
- occult HBV infection
Background & Aims
Morocco is one of low to intermediate endemic areas for hepatitis B virus (HBV) infection, but no reports have been published on Occult HBV infection (OBI). To determine the prevalence of OBI and its clinical impact among patients with cryptogenic and HCV-related chronic liver disease in Morocco.
A total of 152 HBsAg-negative patients (60 patients with cryptogenic hepatitis and 92 HCV carriers) were enrolled in this study. Sera collected from all patients were tested for anti-HBc and anti-HBs antibodies. OBI was assessed in serum and liver tissue samples using highly sensitive PCR assays targeting Surface, X and core regions of the HBV genome and confirmed by Southern blot hybridization.
A high rate of anti-HBc positivity was found among patients with HCV infection (57/92, 61.95%) compared to those with cryptogenic hepatitis (24/60, 40%) (P = 0.034). A high prevalence of OBI was found among patients with HCV infection (42/92, 45.65%) compared to those with cryptogenic hepatitis (17/60, 28.3%) (P = 0.013). In both groups, the prevalence of OBI increased in parallel with advancing stage of liver disease (χ2 = 6.73; P = 0.0095). The highest proportion of OBI was reached among HCV-related HCC cases (62.5%). Multivariate Cox regression analysis revealed that older age (≥56 years), positivity for anti-HBc and presence of OBI were independent risk factors for the development of HCC in HCV-infected patients.
This study helps to understand the current status of OBI and its impact on the severity of liver disease in Moroccan patients.