Occult hepatitis B virus (HBV) infection (OBI) refers to the presence of HBV DNA in the absence of detectable hepatitis B surface antigen (HBsAg). This enigmatic condition poses a considerable challenge for clinicians, as the virus remains hidden, making its detection and subsequent management a complex task. Unlike typical HBV infections where the viral DNA is easily detectable, OBI is characterized by a minimal viral load. This low-level presence of HBV DNA poses a significant hurdle to traditional diagnostic methods, contributing to the underdiagnosis of OBI. OBI is frequently seen in specific groups, especially in people living in endemic for HBV counties and high-risk populations, irrespective of the HBsAg prevalence. Despite its discreet manifestation, OBI holds substantial clinical significance. The persistence of low-level HBV DNA in the liver, even when HBsAg is negative, can lead to severe consequences such as cirrhosis and liver cancer or reactivation in the case of immunosuppression or chemotherapy. This article explores the key characteristics of OBI, its clinical significance, and the challenges associated with its detection.
Keywords: occult hepatitis B infection (OBI), hepatitis B virus (HBV), HBV DNA, prevalence, underdiagnosis.
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Address for correspondence:
Meri Arman HRISTAMYAN
Address: Medical University of Plovdiv, Blvd Vasil Aprilov 15A, Plovdiv, Bulgaria
E-mail: meri.hristamyan@mu-plovdiv.bg; Phone +359883399364
