HEPATITIS-B VIRUS OCCULT INFECTION IN SUBJECTS WITH PERSISTENT ISOLATED ANTI-HBC REACTIVITY

The aim of this study was to investigate the presence of hepatitis B v irus occult infection in asymptomatic subjects with persistent anti-HB c reactivity but no other hepatitis B virus serological markers, inclu ding HBsAg, anti-HBs, IgM anti-HBc and HBV-DNA. For this purpose we us ed both polymerase chain reaction assays in sera and immunohistochemis try for HBsAg and HBcAg in liver biopsy specimens. Twenty-four cases w ere studied: 15 were drug abusers or homosexuals (eight with normal al anine aminotransferase levels) and nine were heterosexuals with raised alanine aminotransferase levels (> 45 U/1) but with no history of blo od transfusion or ethanol intake (< 80 g daily). In all but five cases , liver biopsy was performed in subjects with persistent elevated alan ine aminotransferase levels. In 10 out of 24 cases (41.66%) hepatitis B virus infection was demonstrated by polymerase chain reaction or imm unohistochemistry, and when results from both procedures were availabl e (n = 11) hepatitis B virus infection was detected in 63.63% of the s ubjects. The only clinical feature associated with HBV infection was t he presence of persistent elevated alanine aminotransferase levels (p < 0.05). In conclusion, persistent isolated anti-HBc reactivity may be a relatively common serologic pattern for hepatitis B virus occult in fection, at least in patients with chronic liver disease.