Occult Hepatitis B as a Cause of Cryptogenic Cirrhosis


avatar Zahra Honarkar 1 , * , avatar Seyed Moayed Alavian 2 , avatar Shahram Samiei 2 , avatar Kayvan Saeedfar 2 , avatar Mahnaz Baladast 2 , avatar Rahim Aghazadeh 2 , avatar Mohammad Javad Ehsani 2 , avatar Amir Hoshang Mohammadali Zadeh 2 , avatar Babak NoriNayer 2 , avatar Mohammad Reza Zali 2

Research Center for Gastroenterology and Liver Disease, Shaheed Beheshti University of Medical Sciences, [email protected], Tehran, IR.Iran
Department of Internal Medicine, Baqiyatallah Medical University, Tehran Hepatitis Center, Tehran, IR.Iran

how to cite: Honarkar Z, Alavian S, Samiei S, Saeedfar K, Baladast M, et al. Occult Hepatitis B as a Cause of Cryptogenic Cirrhosis. Hepat Mon.4(8): 155-160.


Background: Occult hepatitis B virus (HBV) infection is characterized by presence of HBV infection with undetectable hepatitis B surface antigen (HBsAg). Diagnosis of occult HBV infection requires sensitive HBV-DNA PCR assay. Recently it has been shown that occult hepatitis B may be a cause of cryptogenic liver disease. The aim of this study is the investigation of occult HBV infection among patients with cryptogenic liver disease.
Methods: 65 consecutive paraffin-embedded liver tissues from cases referred to RCGLD (Research Center for Gastroenterology and Liver Diseases) and THC (Tehran Hepatitis Center) during the years 2001 and 2002 for liver biopsy because of elevation of alanine aminotransferase (ALT) levels for more than six months were studied. Among these, 12 patients with cryptogenic liver disease were found. Human tissue DNA could be extracted in 7 of 12 patients. In these patients liver biopsies were reviewed and HBV-DNA and HBsAg and HBcAg were assayed in liver tissue by polymerase chain reaction (PCR) and immunohistochemistry (IHC), respectively.
Results: Histologically, chronic hepatitis, cirrhosis and nonspecific changes were reported. HBVDNA was detectable in 4 patients but IHC was negative in all. The frequency of occult HBV infection was more than 50%.
Conclusions: Occult HBV infection is common among patients with cryptogenic liver disease. In these patients, HBV-DNA may be detected more frequently among patients with more advanced liver pathology (cirrhosis) and more aggressive clinical course (decompensated cirrhosis).

Full Text

Full text is available in PDF

© 0, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.