Investigating Occult Hepatitis B in Individuals With Family History of Chronic Hepatitis B Virus Infection

Abstract

Objective: Occult hepatitis B (OHB) is defined as identification of hepatitis B virus (HBV) genome in the liver and/or in the serum of HBsAg-negative individuals. We aimed to identify the situation of OHB in persons with chronic HBV infection among family members. Methods: 327 individuals (ages18 and above) who were referred to Infectious Diseases and Clinical Microbiology Outpatient Clinic between 2015 and 2016, and found as HBsAg-negative but learned the presence of chronic HBV infection among their family members (mother, father, spouse, sibling and offspring) were included in the study. HBsAg, anti-HBs and anti-HBc IgG tests were performed by ELISA, and HBV DNA levels were studied by real time polymerase chain reaction (PCR) in the sera. Results: Of the 327 persons included in the study, 168 (51.4%) were female and 159 (48.6%) were male. Only 6 (%1.8) had HBV DNA positivity. Anti-HBc IgG was positive in 110 (33.6%) and anti-HBs in 193 (59%) persons. Of the individuals whose relatives were evaluated; chronic HBV infection was found in 53 (16.2%) mothers, 60 (18.3%) fathers, 84 (25.7%) siblings, 103 (31.5%) spouses, 14 (4.3%) offsprings and in 13 (4.0%) individuals whose combinations consisted of more than one family member. Of the six cases with positive HBV DNA, 3 had spouses with a history of hepatitis B and in 3 cases, a father, brother and offspring had a history of hepatitis B. Conclusions: It is concluded that intrafamilial OHB screening is not required in family members due to the low incidence of OHB and high cost of HBV DNA testing. Considering both community health and cost, it is more appropriate to give family members the necessary education about HBV transmission paths, clinical importance and how to take measures instead of screening to prevent the emergence of new cases.