Research Report
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World J Gastroenterol. Oct 7, 2014; 20(37): 13530-13537
Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13530
Occult hepatitis B virus infection among Mexican human immunodeficiency virus-1-infected patients
Ma Teresa Alvarez-Muñoz, Angelica Maldonado-Rodriguez, Othon Rojas-Montes, Rocio Torres-Ibarra, Fernanda Gutierrez-Escolano, Guillermo Vazquez-Rosales, Alejandro Gomez, Onofre Muñoz, Javier Torres, Rosalia Lira
Ma Teresa Alvarez-Muñoz, Angelica Maldonado-Rodriguez, Othon Rojas-Montes, Guillermo Vazquez-Rosales, Alejandro Gomez, Javier Torres, Rosalia Lira, Unidad de Investigacion Medica en Enfermedades Infecciosas y Parasitarias, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, 06720 Mexico City, Mexico
Rocio Torres-Ibarra, Clinica de Hepatitis, Hospital de Infectologia Centro Médico Nacional La Raza, IMSS, 06720 Mexico City, Mexico
Fernanda Gutierrez-Escolano, Hospital General Regional No. 72, IMSS, 54000 Tlanepantla, Mexico
Onofre Muñoz, Hospital Infantil de Mexico “Federico Gomez”, 06720 Mexico City, Mexico
Author contributions: Alvarez-Muñoz MT and Maldonado-Rodriguez A contributed equally to this work; Alvarez-Muñoz MT and Lira R designed the study and wrote the manuscript; Torres-Ibarra R, Gutierrez-Escolano F and Vazquez-Rosales G provided the patients and the clinical data and also analyzed the data; Maldonado-Rodriguez A and Rojas-Montes O performed all the experiments; Gomez A performed the statistical analyses and participated in the critical review; Muñoz O and Torres J analyzed the data and were also involved in editing the manuscript.
Supported by Consejo Nacional de Ciencia y Tecnologia, Mexico CONACYT 2008-C01-86717, (to Alvarez-Muñoz MT and Lira R)
Correspondence to: Rosalia Lira, PhD, Unidad de Investigacion Medica en Enfermedades Infecciosas y Parasitarias, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Cuauhtemoc 330 Col. Doctores, 06720 Mexico City, Mexico. rolica36@yahoo.com
Telephone: +52-55-56276940 Fax: +52-55-56276949
Received: February 28, 2014
Revised: April 30, 2014
Accepted: May 25, 2014
Published online: October 7, 2014
Abstract

AIM: To determine the frequency of occult hepatitis B infection (OHBI) in a group of human immunodeficiency virus (HIV)-1+/ hepatitis B surface antigen negative (HBsAg)- patients from Mexico.

METHODS: We investigated the presence of OHBI in 49 HIV-1+/HBsAg- patients. Hepatitis B virus (HBV) DNA was analyzed using nested PCR to amplify the Core (C) region and by real-time PCR to amplify a region of the S and X genes. The possible associations between the variables and OHBI were investigated using Pearson’s χ2 and/or Fisher’s exact test.

RESULTS: We found that the frequency of OHBI was 49% among the group of 49 HIV-1+/HBsAg- patients studied. The presence of OHBI was significantly associated with the HIV-1 RNA viral load [odds ratio (OR) = 8.75; P = 0.001; 95%CI: 2.26-33.79] and with HIV-antiretroviral treatment with drugs that interfere with HBV replication (lamivudine, tenofovir or emtricitabine) (OR = 0.25; P = 0.05; 95%CI: 0.08-1.05).

CONCLUSION: The OHBI frequency is high among 49 Mexican HIV-1+/HBsAg- patients and it was more frequent in patients with detectable HIV RNA, and less frequent in patients who are undergoing HIV-ARV treatment with drugs active against HBV.

Keywords: Hepatitis B virus, Occult hepatitis B virus infection, Human immunodeficiency virus, Hepatitis B surface antigen negative, Risk factors, Molecular diagnostics

Core tip: In this study we assessed the frequency of occult hepatitis B infection (OHBI) in a group of 49 human immunodeficiency virus (HIV-1)+/ hepatitis B surface antigen negative (HBsAg)- Mexican patients using a highly sensitive in-house core-nested PCR and real-time PCR assays for hepatitis B virus (HBV) DNA detection. In this study we showed that the frequency of OHBI is high among HIV+/HBsAg- patients and suggests the need for testing HBV DNA in bigger populations utilizing more sentitive assays. Then, we propose to utilize the core-nested PCR assay in the initial screening for OHBI. Prospective studies would be needed to assess the clinical value of this diagnostic approach.