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Occult HBV infection in Morocco: from chronic hepatitis to hepatocellular carcinoma
Author(s) -
Kitab Bouchra,
Ezzikouri Sayeh,
Alaoui Rhimo,
Nadir Salwa,
Badre Wafaa,
Trepo Christian,
Chemin Isabelle,
Benjelloun Soumaya
Publication year - 2014
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12482
Subject(s) - medicine , hepatocellular carcinoma , hbsag , occult , liver disease , hepatitis b virus , gastroenterology , antibody , stage (stratigraphy) , hepatitis b , immunology , virology , virus , pathology , biology , alternative medicine , paleontology
Background & Aims Morocco is one of low to intermediate endemic areas for hepatitis B virus ( HBV ) infection, but no reports have been published on Occult HBV infection ( OBI ). To determine the prevalence of OBI and its clinical impact among patients with cryptogenic and HCV ‐related chronic liver disease in Morocco. Methods A total of 152 HB sAg‐negative patients (60 patients with cryptogenic hepatitis and 92 HCV carriers) were enrolled in this study. Sera collected from all patients were tested for anti‐ HB c and anti‐ HB s antibodies. OBI was assessed in serum and liver tissue samples using highly sensitive PCR assays targeting Surface, X and core regions of the HBV genome and confirmed by Southern blot hybridization. Results A high rate of anti‐ HB c positivity was found among patients with HCV infection (57/92, 61.95%) compared to those with cryptogenic hepatitis (24/60, 40%) ( P = 0.034). A high prevalence of OBI was found among patients with HCV infection (42/92, 45.65%) compared to those with cryptogenic hepatitis (17/60, 28.3%) ( P = 0.013). In both groups, the prevalence of OBI increased in parallel with advancing stage of liver disease (χ2 = 6.73; P = 0.0095). The highest proportion of OBI was reached among HCV ‐related HCC cases (62.5%). Multivariate Cox regression analysis revealed that older age (≥56 years), positivity for anti‐ HB c and presence of OBI were independent risk factors for the development of HCC in HCV ‐infected patients. Conclusion This study helps to understand the current status of OBI and its impact on the severity of liver disease in Moroccan patients.