title: Role of occult hepatitis B virus infection in chronic hepatitis C.
abstract: The development of sensitive assays to detect small amounts of hepatitis B virus (HBV) DNA has favored the identification of occult hepatitis B infection (OBI), a virological condition characterized by a low level of HBV replication with detectable levels of HBV DNA in liver tissue but an absence of detectable surface antigen of HBV (HBsAg) in serum. The gold standard to diagnose OBI is the detection of HBV DNA in the hepatocytes by highly sensitive and specific techniques, a diagnostic procedure requiring liver tissue to be tested and the use of non-standardized non-commercially available techniques. Consequently, in everyday clinical practice, the detection of anti-hepatitis B core antibody (anti-HBc) in serum of HBsAg-negative subjects is used as a surrogate marker to identify patients with OBI. In patients with chronic hepatitis C (CHC), OBI has been identified in nearly one-third of these cases. Considerable data suggest that OBI favors the increase of liver damage and the development of hepatocellular carcinoma (HCC) in patients with CHC. The data from other studies, however, indicate no influence of OBI on the natural history of CHC, particularly regarding the risk of developing HCC.
authors.affiliation: Nicola Coppola, Lorenzo Onorato, Mariantonietta Pisaturo, Margherita Macera, Salvatore Martini, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Coppola
authors.affiliation: Nicola Coppola, Lorenzo Onorato, Mariantonietta Pisaturo, Margherita Macera, Salvatore Martini, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Onorato
authors.affiliation: Nicola Coppola, Lorenzo Onorato, Mariantonietta Pisaturo, Margherita Macera, Salvatore Martini, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors.forename: Mariantonietta
authors.initials: M
authors.lastname: Pisaturo
authors.affiliation: Nicola Coppola, Lorenzo Onorato, Mariantonietta Pisaturo, Margherita Macera, Salvatore Martini, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Macera
authors.affiliation: Nicola Coppola, Lorenzo Onorato, Mariantonietta Pisaturo, Margherita Macera, Salvatore Martini, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Sagnelli
authors.affiliation: Nicola Coppola, Lorenzo Onorato, Mariantonietta Pisaturo, Margherita Macera, Salvatore Martini, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Martini
authors.affiliation: Nicola Coppola, Lorenzo Onorato, Mariantonietta Pisaturo, Margherita Macera, Salvatore Martini, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors.forename: Evangelista
authors.initials: E
authors.lastname: Sagnelli
mesh_terms: D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000821:virology; D060085:Coinfection; D004279:DNA, Viral / Q000097:blood; D018450:Disease Progression; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology*; D008113:Liver Neoplasms / Q000821:virology; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D019562:Viral Load
chemical_list: D015415:Biomarkers; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens
keywords: Cirrhosis; Hepatitis B virus infection; Hepatocellular carcinoma; Occult hepatitis B virus infection; Silent hepatitis B virus infection; anti-hepatitis B core antibody