• Hsing-Yu Chen, Tung-Hung Su, Tai-Chung Tseng, Wan-Ting Yang, Ting-Chih Chen, Pei-Jer Chen, Ding-Shinn Chen, Jia-Horng Kao, and Chun-Jen Liu.
• Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
• J Formos Med Assoc. 2017 Sep 1; 116 (9): 697-704.

Background/PurposeOccult hepatitis B infection (OHB) is not rare in countries that are endemic for hepatitis B virus (HBV) and in patients with chronic hepatitis C virus (HCV) infection. Notably, OHB has been shown to play a role in the progression of liver diseases, including the development of hepatocellular carcinoma (HCC); however, the data is inconsistent. We aim to clarify the contribution of concurrent OHB to the progression of liver diseases in a long-term cohort of patients with HCV infection and to investigate the value of total anti-hepatitis B core (anti-HBc) antibody as a surrogate OHB biomarker.MethodsWe included 250 chronic anti-HCV-positive patients who had resolved HBV infection (anti-HBc positive and hepatitis B surface antigen negative). OHB was then detected using a sensitive commercial assay for serum HBV DNA with a low limit of detection of 6 IU/mL. Clinical outcomes, including the development of liver cirrhosis, HCC, and all-cause deaths, were compared between OHB-positive and OHB-negative patients.ResultsAt baseline, only 183 (73.20%) patients had positive HCV ribonucleic acid, and 56 (30.60%) of these 183 patients with active HCV infection had OHB. The presence of OHB did not correlate with any adverse clinical outcome in multivariate analyses. In addition, chronic hepatitis C patients with OHB did not have a higher level of serum total anti-HBc.ConclusionOHB infection may not contribute to the development of adverse liver outcomes in patients with chronic HCV.Copyright © 2016. Published by Elsevier B.V.

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