ABSTRACT
INTRODUCTION: Occult hepatitis B infection (OBI) may contribute to liver damage and variable therapeutic
response in patients with chronic hepatitis C (CHC) infection.
AIMS: To study the prevalence of OBI and to evaluate its impact and/or that of anti-HBc
total seropositivity on clinical outcomes and response to directly acting antiviral
(DAA) therapy in CHC-infected patients.
SETTINGS AND DESIGN: A retrospective cohort study was conducted in a tertiary care liver hospital from
January to May 2017.
SUBJECTS AND METHODS: Eighty HBsAg-negative CHC patients who were initiated on DAA therapy were retrospectively
included. Archived pretreatment baseline plasma samples were retrieved and tested
for quantitative HBV DNA, anti-HBs, and anti-HBc total antibodies. HCV RNA, genotype,
clinical, biochemical and histopathological parameters & treatment response data were
obtained from the hospital information system.
STATISTICAL ANALYSIS USED: Comparison of continuous variables was done by Mann–Whitney and Kruskal–Wallis tests
and categorical variables by Fisher’s exact test or Pearson’s Chi-square test.
RESULTS: Prevalence of OBI was 1.25%. Anti-HBc total positivity was seen in 25% patients.
Based on anti-HBc total status, patients were categorized into two groups namely Group
1 (anti-HBc positive) and Group 2 (anti-HBc negative). Group 1 patients were further
categorized into three subgroups based on signal/cutoff (S/Co) of HBc total antibody
semi-quantitative values. HBc total antibody levels did not influence the severity
of CHC disease. Comparative evaluation of parameters such as median log10 baseline
RNA (P = 0.929 and 0.464), median alanine aminotransferase (ALT 0) (P = 0.519 and 0.449), ALT at 12 weeks (P = 0.875 and 0.594), sustained virological response (SVR) at 12 weeks (P = 0.405 and 0.263) and SVR at 24 weeks (P = 0.265 and 0.625) between Groups 1 and 2 and among three categories within Group
1, respectively, were not found to be statistically significant.
Conclusions: Very low prevalence of OBI was seen in CHC patients. HBc total antibody levels did
not influence clinical outcome and response to DAA therapy in this cohort.
Keywords
Chronic hepatitis C - directly acting antivirals - occult hepatitis B infection
