Prevalence Of Occult Hepatitis B Infection Among Blood Donors, Pregnant Women And Hemodialysis Patients Of A Tertiary Care Hospital In Puducherry

Abstract

Background: To study the prevalence of occult Hepatitis B infection among blood donors, pregnant women and hemodialysis patients.
Methods: Blood Samples from 150 subjects was initially tested for HBsAg by rapid card method (HEPACARD). Manufacturer’s guidelines were strictly followed.  Samples was initially stored at 4°c until it is tested for HBsAg and later on stored at -80°C. All the samples negative for HBsAg was subjected to HBcAb(total) ELISA using commercially available kit from Dia.Pro Diagnostic. All the samples positive for HBcAb(total) was subjected to RT-PCR to detect HBV core gene. HBV DNA was extracted by DNA extraction kit(HELINI Purefast Viral nucleic acid Mini spin prep kit). Real time PCR was done using HELINI Hepatitis–B virus [HBV] kit.
Results: Among 150 HBsAg negative individuals, 10(7%) were positive for total Anti-HBc and 140 (93%) were negative for Anti-HBc. Out of 10 Anti-HBc positive study participants, 2(20%) were from blood donors, 3(30%) were from haemodialysis patients and 5(50%) were from pregnant women. None of this 10 Anti-HBc positive study participants had previous H/O Hepatitis and HBV vaccination history.  Of these 10 Anti-HBc positive study participants, HBV DNA was detected in 2 study participants. Two positive HBV DNA samples were from blood donors and both were male. The prevalence of Occult Hepatitis B infection in this study was 1.3%.
Conclusion: Anti HBc is a marker seen in acute, chronic, and resolved HBV infections. Because 20% of OBI are seronegative, testing with Anti HBc alone may miss the diagnosis. HBV DNA NAT is costly and unavailable in many resource-constrained, high-endemic countries. To avoid OBI transmission, we should use low-cost, high-sensitivity PCR analysis in Anti HBc and Anti HBs negative high-risk patients especially blood donors.