SCREENING FOR OCCULT HEPATITIS B. INFECTION AMONG CHRONIC LIVER DISEASE PATIENTS ATTENDING TERTIARY CARE HOSPITAL

Background and objectives- Occult Hepatitis B Virus infection (OBI)is defined as a condition when HBsAg virus infection is undetectable in serum, despite the presence of HBV DNA in liver or blood. This study was done to screen for occult hepatitis B infection  among patients with CLD (chronic liver disease) attending gastroenterology OPD of tertiary care hospital.

Materials and methods- Observational Cross-sectional study conducted for period of one year.All patients with history of chronic liver disease were tested for HBsAg by ELISA. All HBsAg negative patients were tested for total antiHBc antibody by ELISA and HBV DNA by real time PCR.

Results- Prevalence of OBI(confirmed OBI) is 2.96% with isolated anti HBc positivity (probable OBI)being 7.24% in this study. Prevalence of seropositive OBI was 1.93% and prevalence of seronegative OBI was 0.96%. Fair agreement was observed between Total antibody against core antigen by ELISA and RTPCR for the diagnosis of OBI(k value=0.354).

Conclusion It is recommended that Total Anti HBc by ELISA may be used as a surrogate marker for diagnosis of OBI in HBsAg negative patients with CLD and for confirmation HBV DNA PCR should be done if molecular facility is available.