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Med J Armed Forces India. 2016 Apr;72(2):140-4. doi: 10.1016/j.mjafi.2016.02.006. Epub 2016 Apr 18.

Prevalence of occult hepatitis B infection in patients visiting tertiary care hospital.

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Senior Adviser (Medicine and Gastroenterology), Command Hospital (Western Command), C/O 56 APO, India.
Graded Specialist (Medicine), 167 Military Hospital, C/O 56 APO, India.
Classified Specialist (Medicine and Gastroenterologist), Army Hospital (R&R), Delhi Cantt 110010, India.



To study the prevalence of occult hepatitis B virus infection (OBI) in a tertiary care hospital.


50 HBsAg negative individuals, each amongst blood donors, alcohol dependence syndrome (ADS), alcoholic cirrhotics, hepatitis C virus (HCV)/cryptogenic cirrhotics, end-stage renal disease (ESRD) on maintenance haemodialysis for one year, all malignancies prior to chemotherapy and HIV positive patients were evaluated for anti-HBc total antibody, and blood hepatitis B virus (HBV) DNA amplification in those tested positive.


A total of 60/369 (16.2%) individuals were anti-HBc total positive, 13/50 (26%) of HCV/cryptogenic cirrhotics, 13/52 (25%) of HIV positive, 10/50 (20%) of patients with malignancy, 10/51 (19.6%) and 7/59 (11.9%) of alcoholic cirrhotics and ADS respectively had intermediate prevalence, while, blood donors 5/55 (9.1%), ESRD patients 2/52 (3.8%) had low prevalence. 12 patients (20% of all anti-HBc total positive cases) were HBV DNA positive, 5 HCV cirrhotics (10% of total HCV/cryptogenic), 4 HIV positive (7.69%), 1 each of ADS (1.69%), alcoholic cirrhotics (1.96%) and malignancy group (2%). Blood donors and ESRD patients were negative for HBV DNA.


HBV DNA amplification may under diagnose OBI and anti-HBc total positivity may be a better surrogate marker. Nucleic acid testing of blood donors, however is preferred, especially in high endemic areas. OBI must be looked for in cirrhotics, HIV infection, and patients with cancers prior to chemotherapy, as they may contribute to morbidity in them.


Cirrhosis; HIV infection; Hepatitis B antibodies; Neoplasms; Occult hepatitis B infection

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