title: Occult hepatitis B infection in children with chronic liver disease.
abstract: OBJECTIVE
  Occult hepatitis B infection (OBI) may adversely affect the outcome of patients with chronic liver disease (CLD). There are no data on OBI and CLD in children. This study determined the prevalence and effect of OBI in HBsAg-negative CLD children.
  
  
  METHODS
  CLD children were prospectively evaluated with a demographic, clinical, and investigative proforma. All HBsAg-negative CLD cases were tested for exposure to hepatitis B (total anti-HBc, anti-HBs). Serum hepatitis B virus DNA was measured in exposed (total anti-HBc positive) patients.
  
  
  RESULTS
  A total of 115 HBsAg-negative CLD children (59 boys, age 9.0±3.6 years) were enrolled. The etiology of CLD was known in 94 cases and 21 children had cryptogenic CLD. Of these, 45 (39.1%) had evidence of HBV exposure (23 total anti-HBc positive, 17 total anti-HBc and anti-HBs positive, five only anti-HBs positive without previous vaccination). The anti-HBc-positive children had a higher Child's score than the anti-HBc-negative children [11 (5-13) vs. 7 (5-13); P=0.00]. A total of 4/45 children had seropositive OBI with serum HBV DNA of 8, 36, 133, and 156 IU/ml, respectively. The proportion of total anti-HBc positivity (8/21 vs. 32/94; P=0.8) and OBI (2/21 vs. 2/94; P=0.1) was similar in cryptogenic CLD and known cause CLD.
  
  
  CONCLUSIONS
  Seropositive OBI is infrequent in Indian children with CLD. The prevalence is similar in cryptogenic and CLD of known etiology.
authors: Departments of aPediatric Gastroenterology bGastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors: Anshu
authors: A
authors: Srivastava
authors: Amrita
authors: A
authors: Mathias
authors: Surender K
authors: SK
authors: Yachha
authors: Rakesh
authors: R
authors: Aggarwal
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D048550:Hepatic Insufficiency / Q000209:etiology*; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies