Molecular and serological detection of occult hepatitis B virus among healthy hepatitis B surface antigen-negative blood donors in Malaysia

Abstract

<div class="section"> <a class="named-anchor" id="d16352626e168"> <!-- named anchor --> </a> <h5 class="section-title" id="d16352626e169">Background</h5> <p id="d16352626e171">Occult hepatitis B infections are becoming a major global threat, but the available data on its prevalence in various parts of the world are often divergent. </p> </div><div class="section"> <a class="named-anchor" id="d16352626e173"> <!-- named anchor --> </a> <h5 class="section-title" id="d16352626e174">Objective</h5> <p id="d16352626e176">This study aimed to detect occult hepatitis B virus in hepatitis B surface antigen-negative serum using anti-HBc as a marker of previous infection. </p> </div><div class="section"> <a class="named-anchor" id="d16352626e178"> <!-- named anchor --> </a> <h5 class="section-title" id="d16352626e179">Patient and methods</h5> <p id="d16352626e181">A total of 1000 randomly selected hepatitis B surface antigen-negative sera from blood donors were tested for hepatitis B core antibody and hepatitis B surface antibody using an ELISA and nested polymerase chain reaction was done using primers specific to the surface gene (S-gene). </p> </div><div class="section"> <a class="named-anchor" id="d16352626e183"> <!-- named anchor --> </a> <h5 class="section-title" id="d16352626e184">Results</h5> <p id="d16352626e186">Of the 1000 samples 55 (5.5%) were found to be reactive, of which 87.3% (48/55) were positive for hepatitis B surface antibody, indicating immunity as a result of previous infection however, that does not exclude active infection with escaped mutant HBV. Nested PCR results showed the presence of hepatitis B viral DNA in all the 55 samples that were positive for core protein, which is in agreement with the hepatitis B surface antibody result. </p> </div><div class="section"> <a class="named-anchor" id="d16352626e188"> <!-- named anchor --> </a> <h5 class="section-title" id="d16352626e189">Conclusion</h5> <p id="d16352626e191">This study reveals the 5.5% prevalence of occult hepatitis B among Malaysian blood donors as well as the reliability of using hepatitis B core antibody in screening for occult hepatitis B infection in low endemic, low socioeconomic settings. </p> </div>