title: Occult HBV infection in Morocco: from chronic hepatitis to hepatocellular carcinoma.
abstract: OBJECTIVE
  Morocco is one of low to intermediate endemic areas for hepatitis B virus (HBV) infection, but no reports have been published on Occult HBV infection (OBI). To determine the prevalence of OBI and its clinical impact among patients with cryptogenic and HCV-related chronic liver disease in Morocco.
  
  
  METHODS
  A total of 152 HBsAg-negative patients (60 patients with cryptogenic hepatitis and 92 HCV carriers) were enrolled in this study. Sera collected from all patients were tested for anti-HBc and anti-HBs antibodies. OBI was assessed in serum and liver tissue samples using highly sensitive PCR assays targeting Surface, X and core regions of the HBV genome and confirmed by Southern blot hybridization.
  
  
  RESULTS
  A high rate of anti-HBc positivity was found among patients with HCV infection (57/92, 61.95%) compared to those with cryptogenic hepatitis (24/60, 40%) (P = 0.034). A high prevalence of OBI was found among patients with HCV infection (42/92, 45.65%) compared to those with cryptogenic hepatitis (17/60, 28.3%) (P = 0.013). In both groups, the prevalence of OBI increased in parallel with advancing stage of liver disease (χ2 = 6.73; P = 0.0095). The highest proportion of OBI was reached among HCV-related HCC cases (62.5%). Multivariate Cox regression analysis revealed that older age (≥56 years), positivity for anti-HBc and presence of OBI were independent risk factors for the development of HCC in HCV-infected patients.
  
  
  CONCLUSIONS
  This study helps to understand the current status of OBI and its impact on the severity of liver disease in Moroccan patients.
authors: Viral Hepatitis Laboratory, Pasteur Institute of Morocco, Casablanca, Morocco.
authors: Bouchra
authors: B
authors: Kitab
authors: Sayeh
authors: S
authors: Ezzikouri
authors: Rhimo
authors: R
authors: Alaoui
authors: Salwa
authors: S
authors: Nadir
authors: Wafaa
authors: W
authors: Badre
authors: Christian
authors: C
authors: Trepo
authors: Isabelle
authors: I
authors: Chemin
authors: Soumaya
authors: S
authors: Benjelloun
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D015999:Multivariate Analysis; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D019562:Viral Load; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004279:DNA, Viral; D006510:Hepatitis B Antibodies
keywords: chronic HCV infection; cryptogenic hepatitis; hepatitis B virus; hepatocellular carcinoma; occult HBV infection