title: The detection of occult HBV infection in patients with HBsAg negative pattern by real-time PCR method.
abstract: OBJECTIVE
  Diagnostic problems may be encountered in Hepatitis B virus (HBV) infections by serological tests and HBV DNA can be detectable in plasma and liver tissue while the HBsAg test is negative. This situation can be defined as occult or isolated Anti-HBc infections. Occult HBV infections may be divided into two categories by using hepatitis markers. One of them being that all hepatitis markers are negative and the other situation is having Anti-HBc +/- and Anti-HBs+patterns. These situations can be seen in isolated Anti-HBc cases.
  
  
  METHODS
  In this study, we aimed to detect the ratio of occult HBV infections by investigating HBV DNA in four different groups. These groups are: (1) 20 isolated Anti-HBc positive individuals, (2) 23 individuals naturally immune to HBV infection, (3) 20 individuals with seronegative hepatitis markers and high ALT levels, and (4) 23 vaccinated individuals against HBV. In order to detect HBV DNA the real-time PCR kit (QIAGEN, Artus HBV RG PCR Kit, Germany) with high analytical sensitivity (≤3.8IU/ml) was used.
  
  
  RESULTS
  The reliability of the molecular methods was assessed by increasing the quantitation standards of internal, external and also positive controls. No HBV DNA was detected in any of the 86 individuals consisting of four study groups.
  
  
  CONCLUSIONS
  In conclusion, we did not detect occult HBV infection in our four study groups by using a high sensitivity real-time (RT) PCR method, while occult HBV infections with various frequencies were detected in other large, serial international studies in which highly sensitive analytical molecular methods were used. Although we also used a high standard molecular kit to detect occult HBV infections, we suggest that the reason for the absence of detection of occult HBV infections may be due to the small number of cases included in this study. However, it was assumed that the use of a nucleic acid amplification technology (NAT) with high analytical sensitivity in blood banks to prevent HBV transmission by blood transfusion is controversial due to both costs and diagnostic efficacy and for this reason we suggest that it will be useful to perform large serial studies regarding occult HBV infections in the future.
authors.affiliation: Microbiology and Clinical Microbiology Department, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Sena
authors.initials: S
authors.lastname: Izmirli
authors.forename: Deniz Gozde
authors.initials: DG
authors.lastname: Celik
authors.forename: Pelin
authors.initials: P
authors.lastname: Yuksel
authors.forename: Suat
authors.initials: S
authors.lastname: Saribas
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aslan
authors.forename: Sevgi
authors.initials: S
authors.lastname: Ergin
authors.forename: Hrisi
authors.initials: H
authors.lastname: Bahar
authors.forename: Sümeyye
authors.initials: S
authors.lastname: Sen
authors.forename: Bulent
authors.initials: B
authors.lastname: Cakal
authors.forename: Ali
authors.initials: A
authors.lastname: Oner
authors.forename: Bekir
authors.initials: B
authors.lastname: Kocazeybek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood* / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens