title: Occult HBV infection among anti-HBc positive HIV-infected patients in apex referral centre, Eastern India.
abstract: BACKGROUND
  The prevalence of occult HBV, defined by the presence of HBV DNA in individuals with antibodies to HBV core antigen and with absence of HBV surface antigen, but its clinical significance and virological features in HIV-infected patients is still unclear.
  
  
  OBJECTIVE
  To investigate the prevalence, clinical significance and molecular characterization of occult hepatitis B virus infection in ART-Naive HIV-positive individuals.
  
  
  METHODS
  Among the 1077 HIV-infected patients with different risk factors for HIV infection, 297 were HBsAg-ve ART-naive, of them 112 was randomly selected for the study. HBV DNA was tested by in-house PCR and quantified by qPCR. Molecular characterization was performed by sequencing the envelope and overlapping polymerase genes.
  
  
  RESULTS
  We found the prevalence of occult HBV to be 10.7% among a randomly selected group of HBsAg-ve/antiHBc+ve HIV-infected patients. Overall 33.9% (38 of 112) of the patients were antiHBc positive indicating exposure to HBV infection. HBV DNA was detected in 12/38 (31.5%) antiHBc positive samples and 50% of them had CD4 T cell count < 200 cells/mm(3). HCV coinfection was low (2.7%). No surrogate marker for OBI could be identified. Presence of antiHBs antibodies did not rule out OBI. Liver biopsy in six cases showed varying stages of chronic hepatitis. Several mutations were detected but not the common immune escape mutant G145R.
  
  
  CONCLUSIONS
  In conclusion the prevalence of OBI was significantly high among HIV coinfected patients, which highlights the importance of HBV DNA testing in these patients and indicates need for further prospective studies in larger cohorts to assess its clinical significance.
authors.affiliation: ICMR Virus Unit, Kolkata, West Bengal, India.
authors.forename: R
authors.initials: R
authors.lastname: Panigrahi
authors.forename: S
authors.initials: S
authors.lastname: Majumder
authors.forename: M
authors.initials: M
authors.lastname: Gooptu
authors.forename: A
authors.initials: A
authors.lastname: Biswas
authors.forename: S
authors.initials: S
authors.lastname: Datta
authors.forename: P K
authors.initials: PK
authors.lastname: Chandra
authors.forename: A
authors.initials: A
authors.lastname: Banerjee
authors.forename: S
authors.initials: S
authors.lastname: Chakrabarti
authors.forename: D
authors.initials: D
authors.lastname: Bandopadhyay
authors.forename: B K
authors.initials: BK
authors.lastname: De
authors.forename: R
authors.initials: R
authors.lastname: Chakravarty
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D060085:Coinfection; D004279:DNA, Viral / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology*; D006512:Hepatitis B Core Antigens / Q000097:blood*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D012017:Referral and Consultation; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004279:DNA, Viral; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D012367:RNA, Viral