Prevalence,clinical features, and virological characteristics of occult HBV infection in patients with autoimmune hepatitis

Abstract

Abstract: Objective To investigate the prevalence, clinical features, and virological attributes of occult hepatitis B virus (HBV) infection (OBI) in patients with autoimmune hepatitis (AIH). Methods Between April 2010 and April 2023, 318 patients with AIH admitted to our hospital were tested for HBV DNA. These patients were categorized into groups with combined OBI and without OBI based on thequantification of HBV DNA. We analyed the prevalence, clinical features, and laboratory indices for each group. Viral vectors were assessed using fluorescent polymerase chain reaction, HBV genotyping, and the virological characteristics and mutations associated with AIH combined with OBI were also examined. Results 318 patients diagnosed with AIH were assessed, and 41 of them (12.9%) were found to have a concurrent OBI. The proportion of patients with combined OBI exhibiting seropositivity for anti-hepatitis B core antibody (anti-HBc), hepatitis B surface antibody (anti-HBs), and hepatitis B e antibody (anti-HBe) was 41.5%, significantly exceeding the 17.3% in patients without OBI(P<0.05). The predominant HBV genotypes in the OBI combined cases were type B and C, with 23 cases of type B and 17 of type C identified. The viral load was highest in patients with anti-HBc and anti-HBe positivity at (685.3±154.7) IU/mL. This load decreased sequentially in those with anti-HBc and anti-HBs positivity, anti-HBc positivity alone, and combined anti-HBc, anti-HBs and anti-HBe positivity, with respective values of (465.8±134.5) IU/mL, ( 323.6±103.6) IU/mL, (131.4±83.4) IU/mL(P<0.05). Additionally, 11 patients in the group with combined OBI were found to have “a”determinant mutations on detection of HbsAg were detected. Representing 26.8% of these cases. Conclusion Patients with AIH are at a higher risk of OBI infection, typically indicated by positivity for anti-HBc, anti-HBs, and anti-HBe. The viral genes in AIH cases combined with OBI predominantly belong to types B and C. Moreover, AIH combined with OBI infection is commonly associated with T126A and Q129 mutations.

Key words: Autoimmune hepatitis, Occult hepatitis B virus infection, Clinical Characteristics, Virological characteristics

LI Yue-mei, YAO Xuan, LV Jin, XU Jing-ru. Prevalence,clinical features, and virological characteristics of occult HBV infection in patients with autoimmune hepatitis[J]. Chinese Hepatolgy, 2024, 29(5): 567-570.

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