Study of occult hepatitis b virus among iranian hemophilia patients with chronic hepatitis c after direct-acting antiviral therapy

Niloofar Naderi,1,* Azam bolhassani,2

1. 1Department of Hepatitis and AIDS, Pasteur Institute of Iran, Tehran, Iran 2Iranian Comprehensive Hemophilia Care Center
2. 1Department of Hepatitis and AIDS, Pasteur Institute of Iran, Tehran, Iran 2Iranian Comprehensive Hemophilia Care Center

Abstract

Introduction

In most co-infected patients, hcv suppressed hbv replication, thus, the lack of hbv suppression following hcv successful treatment could lead to hbv reactivation. occult hepatitis b infection (obi) is defined as the continuous existence of the hbv genome in liver tissues and/or serum in the absence of serum hbsag. hbv may reactivate when treating chronic hepatitis c (chc) with direct-acting antivirals (daa). this study determined the prevalence of obi in iranian hemophilia patients receiving daa agents for hcv infection.

Methods

The peripheral blood samples from 100 hemophilia patients who received daas were enrolled. the sera obtained from these patients were tested for the presence of hbsag. then, the presence of the hbv dna was detected in pbmc and also plasma samples using nested pcr. the results of demographic information of patients were reported as the mean ± standard deviation using spss or excel software.

Results

Among 100 hemophilia patients, 81 (81%) were male and 19 (19%) were female. all patients included were negative for hbsag. compared to no hbv activation in 100 hbsag-negative patients, hbv dna was found in 1% of plasma and in 3% of pbmc samples.

Conclusion

Generally, the prevalence of occult hbv infection was low, but however, hbsag negativity was not sufficient to exclude the presence of hbv dna, completely. thus, patients with obi treated with daa against hcv should be monitored for hbv reactivation after daa treatment, even though hbv may be inactive at the time of treatment initiation.

Keywords

Hemophilia, hbv, hcv, hbv reactivation, nested pcr