Occult Hepatitis B in Patients Co-Infected With Hepatitis C and Human Immunodeficiency Viruses

Diagnosis of the occult hepatitis B virus (HBV) infection in patients co-infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is important due to the fact that the HBV infection may have a clinical impact on liver disease in coinfected HIV/HCV patients. Isolated hepatitis B core antibody (HBcAb) positive HBV infection has been reported in HIV patients. The aim of this study was to determine the occult hepatitis B in patients co-infected with HCV-HIV. In a cross-sectional study, hepatitis B surface antigen (HBsAg) and HBcAb tests were performed for all HIV-HCV co-infected patients, referred to the HIV Clinic of Hamadan. HBsAb was requested for HBsAg negative-HBcAb positive individuals and in the case of negative HBsAb, HBV-DNA PCR was performed. Finally the collected data was analyzed with SPSS. Of 103 HIV-HCV coinfected patients, both HBsAg and HBcAb were positive in 7 patients (6.8%), negative in 44 (42.7%) patients and 52 (50.5%) of all patients were HBsAg negative and HBcAb positive, which positivity of HBsAg had statistical correlation with positivity of HBcAb. In the last group HBsAb and HBV-DNA PCR were done, which resulted in the titer of antibody to be positive in 4 patients (7.7%) and the PCR to be negative in all (100%) patients. The significant number of coinfected HIV-HCV patients only had HBcAb positive test without detectable HBV-DNA. Further studies for detection of HBV-DNA in both serum and liver biopsy specimens may help clarify the impact of HBV infection in coinfected HIV/HCV patients.