Occult hepatic B viral infection in children: important public health issues
DOI:
https://doi.org/10.52556/2587-3873.2023.4(97).08Keywords:
HBsAg, occult HBV infection, cccADNAbstract
Occult hepatitis B virus infection (OBI) is of important clinical significance and represents a specific phase of the viral infectious process in which HBsAg-negative individuals have reduced viral DNA replication, detectable or undetectable in serum but present in the liver. Materials and methods. A review of the Pub Med database on occult HBV infection from January 2013 to April 2023 was performed, selecting publications pertaining to children. Results. Of the 914 identified articles, 111 publications met the selection criteria of “occult HBV infection in children”. In this phase, covalently closed circular DNA (cccADN) is in a low replication state. Mechanisms of suppression of HBV replication activity have been shown to be related to host immune control and epigenetic factors. The prevalence of occult HBV infection in adults varies widely in different geographic regions and depends on risk factors for parenteral infections and the sensitivity of tests used to detect HBsAg and HBV DNA. Occult HBV infection in children is a poorly understood problem, with a prevalence of 20-54%. HBV can be transmitted parenterally, by blood transfusion, habitual transmission, or liver transplantation, causing acute hepatitis, reactivating with immunosuppression, accelerating the progression of chronic hepatitis to cirrhosis, and contributing to malignancy. Conclusions. Occult HBV infection in children is one of the clinical forms of chronic HBV infection with varying overall prevalence. Anti-HBcor is an important diagnostic marker, and their testing for hepatitis of unknown etiology in children will detect chronic HBV infection.
References
1. Hollinger F.B. Hepatitis B virus infection and transfusion medicine: science and the occult. In: Transfusion, 2008. Vol. 48 (5), pp. 1001-1026. https://doi.org/10.1111/j.1537-2995.2008.01701.x
2. Hollinger F.B., Sood G. Occult hepatitis B virus infection: a covert operation. In: J. Viral Hepat., 2010. Vol. 17 (1), pp. 1-15. https://doi.org/10.1111/j.1365-2893.2009.01245.x
3. Hu K.Q. Occult hepatitis B virus infection and its clinical implications. In: J. Viral Hepat., 2022. Vol. 9 (4), pp. 243-257. https://doi.org/10.1046/j.1365-2893.2002.00344.x
4. Morozov I.A., Il'chenko L.Yu., Fedorov I.G. i dr. Skrytyy gepatit V: klinicheskoye znacheniye i problemy diagnostiki. Arkhiv vnutrenney meditsiny, 2012. No.4(6), pp. 39-45.
5. Cacciola I., Pollicino T., Squadrito G. et al. Occult Hepatitis B Virus Infection in Patients with Chronic Hepatitis C Liver Disease. In: N Engl J Med, 1999. Vol. 341, pp. 22-26. https://doi.org/10.1056/NEJM199907013410104
6. World Health Organization: World Hepatitis Day 2017 - Eliminate hepatitis. who.int/campaigns/hepatitis-day/2017/event/ru/.
7. World Health Organization: Hepatitis B. 12 July 2023. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b.
8. Raimondo G., Pollicino T., Romano L. et al. A 2010 update on occult hepatitis B infection. In: Pathol Biol. Paris. 2010, Vol. 58 (4), pp. 254-257. https://doi.org/10.1016/j.patbio.2010.02.003
9. Caviglia G., Abate M., Tandoi F. et al. Quantation of HBV cccDNA in anti-HBc-positive liver donors by droplet digital PCR: Anew tool to derect occult infection. In: Journal of Hepatology, 2018. Vol. 69, pp. 301-307. https://doi.org/10.1016/j.jhep.2018.03.021
10. Luca A. Tehnica Real-Time PCR pentru detecția și cuantificarea genotipurilor de virus hepatic B. Iasi, 2017, 25 p.
11. Raimondo G., Allain J., Brunetto M. et al. Statements from the Taormina expert meeting on occult hepatitis B virus infection. In: J Hepatol, 2008. Vol. 49, pp. 652-657. https://doi.org/10.1016/j.jhep.2008.07.014
12. Hoofnagle J.H., Seeff L.B., Bales Z.B. et al. Type B hepatitis after transfusion with blood containing antibody to hepatitis B core antigen. In: N Engl J Med, 1978. Vol. 298, pp.1379-1383. https://doi.org/10.1056/NEJM197806222982502
13. Raimondo G., Locarnini S., Pollicino T. et al. Taormina Workshop on Occult HBV Infection Faculty Members Actualizare a declarațiilor privind biologia şi impactul clinic al infecției cu virusul hepatitei B oculte. In: J. Hepatol, 2019. Vol. 71, pp. 397-408.
14. Saitta C., Musolino C., Marabello G. et al. Risc de reactivare ocultă a infecției cu virusul hepatitei B la pacienții cu tumori solide supuşi chimioterapiei. In: Săpa. Ficat Dis, 2013. Vol. 45, pp. 683-686. https://doi.org/10.1016/j.dld.2013.01.022
15. EASL 2017. Clinical Practisis Guidelines on the management of hepatitis B virus infection. In: J Hepatol, 2017. Vol. 67 (2), pp. 370-398. https://doi.org/10.1016/j.jhep.2017.03.021
16. Sokal E., Paganelli M., Wirth S. et al. Management of chronic hepatitis B in childhood: ESPGHAN Clinical Practice Guidelines. In: Journal of Hepatology, 2013. Vol. 59, pp. 814 - 829. https://doi.org/10.1016/j.jhep.2013.05.016
17. Ji D.Z., Pang X.Y., Shen D.T. et al. Global prevalence of occult hepatitis B: A systematic review and meta-analysis. In: J. Viral. Hepat, 2022. Vol. 29, pp. 317-329. https://doi.org/10.1111/jvh.13660
18. Yokoyama K., Kumagai H., Takahashi M. et al. Occult hepatitis B virus infection in immunized children born to carrier mothers. In: J. Pediatr Int., 2017. Vol. 59 (9), pp. 1010-1016. https://doi.org/10.1111/ped.13352
19. Ghaziasadi A., Fakhari Z., Aghcheli B. et al. High prevalence of occult hepatitis B infection (OBI) among healthy children and their parents in Alborz province, Iran; Vertical OBI, myth or truth? In: Liver International, 2019. Vol. 40 (1), pp. 92-100. https://doi.org/10.1111/liv.14252
20. Escobedo-Melendez G., Panduro A., Fierro N. A. et al. High prevalence of occult hepatitis B virus genotype H infection among children with clinical hepatitis in west Mexico. In: Mem Inst Oswaldo Cruz, 2014. Vol. 109 (6), pp.728-37. https://doi.org/10.1590/0074-0276140058
21. Srivastava A., Mathias A., Yachha S-K. et al. Occult hepatitis B infection in children with chronic liver disease. In: Eur J Gastroenterol Hepatol, 2015. Vol. 27 (4). pp. 375-7. https://doi.org/10.1097/MEG.0000000000000294
22. Hung W-L., Wu J-F., Ni Y-H. et al. Occult hepatitis B virus and surface antigen mutant infection in healthy vaccinated cohorts and children with various forms of hepatitis and multiple transfusions. In: Liver International, 2019. Vol 39 (6). pp. 1052-1061. https://doi.org/10.1111/liv.14076
23. Liu Y., Wen J., Chen J. et al. Rare Detection of Occult Hepatitis B Virus Infection in Children of Mothers with Positive Hepatitis B Surface Antigen. In: PLOS One, 2014. Vol. 9 (11): e112803. https://doi.org/10.1371/journal.pone.0112803
24. Su H., Zhang Y., Xu D. et al. Occult Hepatitis B Virus Infection in Anti-HBs-Positive Infants Born to HBsAg-Positive Mothers in China. In: PLOS One, 2013. Vol 8(8): e70768. https://doi.org/10.1371/journal.pone.0070768
25. Yang R., Song G., Guan W. et al. The Lumipulse G HBsAg-Quant assay for screening and quantification of the hepatitis B surface antigen. In: Journal of Virological Methods, 2016. Vol. 228. pp. 39 - 47. https://doi.org/10.1016/j.jviromet.2015.11.016
26. Pande C., Sarin S.K., Patra S. et al. Hepatitis B vaccination with or without hepatitis B immunoglobulin at birth to babies born of HBsAg-positive mothers prevents overt HBV transmission but may not prevent occult HBV infection in babies: a randomized controlled trial. In: Journal of Viral Hepatitis, 2013. Vol. 20 (11). pp. 801-810. https://doi.org/10.1111/jvh.12102
27. Lu Y., Liu Y.L., Nie J.J. et al. Occult HBV Infection in Immunized Neonates Born to HBsAg-Positive Mothers: A Prospective and Follow-Up Study. In: PLOS One, 2016. Vol. 11 (11): e0166317. https://doi.org/10.1371/journal.pone.0166317
28. Eilard A., Andersson M., Ringlander J. et al. Vertically acquired occult hepatitis B virus infection may become overt after several years. In: J Infect, 2019. Vol. 78 (3). pp. 226-231. https://doi.org/10.1016/j.jinf.2019.01.002
29. Zhuge S., Ge C., Yang Y. et al. The prevalence of occult HBV infection in immunized children with HBsAg-positive parents: a hospital-based analysis. In: Hepatol Int, 2020. Vol. 14 (4). pp. 503-512. https://doi.org/10.1007/s12072-020-10055-9
30. Elrashidy H., El-Didamony G., Elbahrawy A. et al. Absence of occult hepatitis B virus infection in sera of diabetic children and adolescents following hepatitis B vaccination. In: Hum Vaccin Immunother, 2014. Vol. 10 (8). pp. 2336-2341. https://doi.org/10.4161/hv.29521
31. Raouf H.E., Yassin A.S., Megahed S.A. et al. Seroprevalence of occult hepatitis B among Egyptian paediatric hepatitis C cancer patients. In: J Viral Hepat, 2015. Vol. 22 (2). pp. 103-11. https://doi.org/10.1111/jvh.12260
32. Guruprasad B., Kavitha S., Aruna Kumari BS et al. Risk of hepatitis B infection in pediatric acute lymphoblastic leukemia in a tertiary care center from South India. In: Pediatric Blood & Cancer, 2014. Vol. 61 (9). pp. 1616-1619. https://doi.org/10.1002/pbc.25065
33. Dapena M., Figueras C., Noguera-Julian A. et al. Implementation of occult hepatitis screening in the Spanish cohort of HIV-infected pediatric patients. In: Pediatr Infect Dis J, 2013. Vol. 32 (9): e377-9. https://doi.org/10.1097/INF.0b013e31828e9b99
34. Li Y., Li L., Song Y. et al. Booster Vaccination in Infancy Reduces the Incidence of Occult HBV Infection in Maternal HBsAg-positive Children. In: Journal of Clinical and Translational Hepatology, 2023. Vol. 11 (3). pp. 661-669.
35. Foaud H., Maklad S., Mahmoud F. et al. Occult hepatitis B virus infection in children born to HBsAg-positive mothers after neonatal passive-active immunoprophylaxis. In: Infection, 2015. Vol. 43. pp. 307-314. https://doi.org/10.1007/s15010-015-0733-6
36. Su H., Shao Z., Pu Z. et al. Overt and occult hepatitis B virus infection among community children in Northwest China. In: Journal of Viral Hepatitis. Vol. 24. (9). pp. 797-803. https://doi.org/10.1111/jvh.12709
37. Raba T. Hepatitele virale B, C, D cronice la copii. Monografie. Chişinău, 2016, capitol III pp. 69-118.
38. Kwak M.S., Kim Y.J. Occult hepatitis B virus infection. In: World J Hepatol, 2014. Vol. 6(12). pp. 860-869. https://doi.org/10.4254/wjh.v6.i12.860
39. Cheung C.K., Lo C.M., Man K. et al. Occult hepatitis B virus infection of donor and recipient origin after liver transplantation despite nucleoside analogue prophylaxis. In: Liver Transplatation, 2010. Vol. 16 (11). pp. 1314-1323. https://doi.org/10.1002/lt.22169
40. Raimondo G., Caccamo G., Filomia R. et al. Occult HBV infection. In: Semin Immunopathol. 2013. Vol. 35, pp. 39-52. https://doi.org/10.1007/s00281-012-0327-7
41. Samuel D., Forns X., Berenguer M. et al. Report of the Monothematic EASL Conference on Liver Transplantation for Viral Hepatitis: (Paris, France, January 12-14, 2006). In: J Hepatol. 2006, Vol. 45, pp. 127-143. https://doi.org/10.1016/j.jhep.2006.05.001
42. Cui F.Q., Shen L.P., Li L. et al. Prevention of Chronic Hepatitis B after 3 Decades of Escalating Vaccination Policy, China. In: Emerg Infect Dis. 2017. Vol. 23(5), pp. 765-772. https://doi.org/10.3201/eid2305.161477
43. Funk A.L., Lu Y., Yoshida K. et al. Efficacy and safety of antiviral prophylaxis during pregnancy to prevent mother-to-child transmission of hepatitis B virus: a systematic review and meta-analysis. In: Lancet Infect Dis. 2021. Vol. 21(1), pp. 70-84. https://doi.org/10.1016/S1473-3099(20)30586-7
44. Chen, H.L., Lee C.N., Chang C.H. et al. Efficacy of maternal tenofovir disoproxil fumarate in interrupting mother-to-infant transmission of hepatitis B virus. In: Hepatology. 2015. Vol. 62(2), pp. 375-386. https://doi.org/10.1002/hep.27837
45. Shahmoradi S., Yahyapour Y., Mahmoodi M. et al. High prevalence of occult hepatitis B virus infection in children born to HBsAg-positive mothers despite prophylaxis with hepatitis B vaccination and HBIG. In: J Hepatol. 2012. Vol. 57(3), pp. 515-521. https://doi.org/10.1016/j.jhep.2012.04.021
46. Zhou S., Li T.T., Allain J.P. et al. Low occurrence of HBsAg but high frequency of transient occult HBV infection in vaccinated and HBIG-administered infants born to HBsAg positive mothers. In. J Med Virol. 2017. Vol. 89(12), pp. 2130-2137. https://doi.org/10.1002/jmv.24861
47. Li Y., Liu Z.X., Song Y.R. et al. Reduction of the occurrence of occult HBV infection in infants by increasing the dose of hepatitis B vaccine: a large prospective cohort study. In: Microbii emergenti infectează 2020. Vol. 9(1), pp. 1881-1891. https://doi.org/10.1080/22221751.2020.1808533
48. Hsu H.Y., Chen H.L., Wu J.F. et al. Occult Hepatitis B Virus Infection in Immunized Infants Born to Untreated and Tenofovir-Treated Highly Viremic Mothers. In: Clin Gastroenterol Hepatol. 2021. Vol. 19(7), pp. 1494-1496. https://doi.org/10.1016/j.cgh.2020.07.041
49. Hu A.Q., Cai Q.Y., Zhang M. et al. Overt and occult hepatitis B infection after neonatal vaccination: mother-to-infant transmission and HBV vaccine effectiveness. In: Int J Infect Dis. 2021. Vol. 104, pp. 601-609. https://doi.org/10.1016/j.ijid.2021.01.045
50. Candotti D., Assennato S.M., Laperche S. et al. Multiple HBV transfusion transmissions from undetected occult infections: revising the minimal infectious dose. In: Gut 2019. Vol. 68(2), pp. 313-321. https://doi.org/10.1136/gutjnl-2018-316490
51. Candotti D., Laperche S. Hepatitis B Virus Blood Screening: Need for Reappraisal of Blood Safety Measures? In: Front Med, 2018. Vol. 5, pp. 29. https://doi.org/10.3389/fmed.2018.00029
52. Akram A., Islam S.M.R., Munshi S.U., et al. Detection of hepatitis B virus DNA among chronic and potential occult HBV patients in resource-limited settings by loop-mediated isothermal amplification assay. In: J Viral Hepat, 2018. Vol. 25, pp. 1306 - 1311. https://doi.org/10.1111/jvh.12931
53. Paul S., Saxena A., Terrin N. et al. Hepatitis B Virus Reactivation and Prophylaxis During Solid Tumor Chemotherapy. In: Ann Intern Med. 2016. Vol. 164, pp. 30-40. https://doi.org/10.7326/M15-1121
54. Levast M., Larrat S., Thelu M.A. et al. Prevalence and impact of occult hepatitis B infection in chronic hepatitis C patients treated with pegylated interferon and ribavirin. In: Journal of Medical Virology, 2010. Vol. 82(5), pp. 747-754. https://doi.org/10.1002/jmv.21695
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
