P24: Occult hepatitis B infection among vaccinated cohort

Iranian journal of microbiology, 2014

Although hepatitis B vaccine immunogenicity is high, certain risk factors such as age, tobacco consumption, obesity and genetic background have been associated with low responsiveness to HBV vaccine. We aimed to evaluate the role of occult hepatitis B virus (HBV) infection in non-responder adults to HBV vaccine in a low endemic area for HBV. A total of 52 subjects who were non-responder to HBV vaccine were enrolled in the study. HBsAg, anti-HBs and anti-HBc were tested in all subjects. The presence of HBV-DNA was determined in plasma samples by real-time PCR. A total of 52 cases with median age 34 years were enrolled in the study. 63.5% of patients were male and 36.5% were female. Isolated anti-HBc (HBsAg negative, anti-HBs negative and anti-HBc positive) was detected in 3.8% of cases. HBV-DNA was not detected in our cases. This study showed no evidence of occult HBV infection in our HBV vaccine non-responders even in cases with isolated anti-HBc.

BACKGROUND AND OBJECTIVES: Hepatitis B core antibodies (anti-HBc) are detected in almost every patient with previous exposure to hepatitis B virus (HBV). However, with this marker alone, one cannot understand the activity of the disease; therefore, this study aimed to identify the implication of isolated hepatitis B core antibody and evaluate the effect of hepatitis B vaccine booster in isolated anti-HBc among adults who received the HBV vaccine as infants. DESIGN AND SETTINGS: A prospective cohort study of vaccinated undergraduate students of University Putra Malaysia. PATIENTS AND METHODS: A total of 408 undergraduate students who received infant hepatitis B vaccination volunteered for this study; 5 mL of venous blood was taken from the volunteers. Hepatitis B surface antigen (HBsAg) and core antibodies were tested using a commercially available enzyme-linked immunosorbent assay kit according to the manufacturer's instructions (DRG international Inc., USA). Molecular detection of hepatitis B viral DNA was performed using nested polymerase chain reaction. RESULTS: The prevalence of isolated anti-HBc among the vaccinated cohort was found to be 5.0%, out of which 80% had a hepatitis B surface antibodies (anti-HBs) titer higher than 10 IU/L, while 20% had less than 10 IU/L anti-HBs titer. All the anti-HBc positivesubjects had detectable hepatitis B viral DNA in their serum. Anamnestic response was found to be 100% among isolated anti-HBc with negative antibody. CONCLUSION: Isolated anti-HBc developed protective levels of anti-HBs after a single dose of recombinant hepatitis B vaccination. HBV DNA was detected in all isolated anti-HBc indicating occult chronic HBV infection with undetectable HBsAg.

Acta medica Iranica, 2008

Diagnosis of hepatitis B is routinely based on of serological assay of hepatitis B surface antigen (HBsAg). Occult hepatitis B virus (HBV) infection is generally defined as the detection of HBV -DNA in the serum or tissues of subjects who have negative test for HBsAg. Transmission of HBV infection has been documented from HBsAg negative, anti-HBc positive blood and organ donors. The aim of this study was to determine the rate of occult HBV infection among HBsAg negative and anti-HBc positive blood donors of Rafsanjan blood transfusion center. ‎ Sera from 270 healthy blood donors who were negative for both HBsAg and anti-HCV, were tested for anti-HBc antibodies by use of ELISA technique. The samples that were negative for HBsAg but positive for anti-HBc markers also examined for the presence of HBV-DNA by polymerase chain reaction (PCR). ‎ Out of 270 HBsAg negative blood samples, 14 samples (5.18%) were positive for anti-HBc antibodies. HBV-DNA was detected in 4/14 (28.57%) of HBsAg ...

International Journal of Infectious Diseases, 2010

Germs, 2015

Background Worldwide, healthcare workers (HCWs) show different levels of response to hepatitis B virus (HBV) vaccine. One of the factors associated with vaccine unresponsiveness may be the existence of current or past HBV infection. Regardless of the presence of HBsAg (overt infection), occult HBV infection (OBI, defined as presence of HBV DNA in the absence of HBsAg) might also account for some non-or hypo-response cases. Methods Sera from 120 HBsAg-negative HCWs with low and moderate levels of anti-HBs, <10 IU/mL (group I) and <100 IU/mL (group II) respectively, were selected and were examined for OBI by sensitive real-time PCR regardless of HBV serological profiles. Direct sequencing on surface genes was carried out in OBI-positive cases. Results Four (3.3%) were positive for OBI. All were negative for anti-HBc. Two of the positive cases had moderate levels of anti-HBs (>10 to <100 IU/mL). No significant differences were found between the two groups in terms of risk factors or serological data. No mutations were found in surface proteins of OBI cases. Conclusion OBI in these subjects might be due to other factors rather than presence of "a" determinant mutations. Healthcare workers with inadequate to moderate levels of anti-HBs (<100 IU/mL) following vaccination, regardless of their serological profile for HBV, should be tested for the presence of HBV DNA by sensitive molecular tests. Anti-HBc is not a reliable marker for suspicion of OBI, especially in high-risk group individuals. Keywords Healthcare workers, hepatitis B virus, HBV, HBV vaccine Background 1 Globally, hepatitis B virus (HBV) is a major public health problem in both industrial and

Medicine, 2016

The presence of anti-hepatitis B virus (HBV) core antibody (anti-HBc) is considered a sensitive lifetime marker of HBV infection. Here, we examined this dogma by investigating the prevalence of hepatitis B viremia in anti-HBc negative complete vaccines in Taiwan. A total of 795 participants (1.7-20.0 years old) had completed HBV vaccination in infancy and were anti-HBc negative. Serum samples were available for 460 individuals with isolated anti-HBV surface antibodies (anti-HBs) (HBsAg-negative and anti-HBc negative) and for 245 individuals who tested negative for all 3 markers (triple seronegative). All samples were submitted for polymerase chain reaction (PCR) targeting both the preS/S and X/pre-C gene regions. Of the 460 participants with isolated anti-HBs, 26 (5.65%) were positive for HBV by 2-target PCR. Of the 245 triple seronegative samples, 12 (4.90%) were positive for HBV DNA. In the former group, the prevalence of viremia was significantly higher in individuals aged 6 to 10 years than in all other ages combined (11.82% vs 3.7%, P = 0.001). The anti-HBs titers were significantly lower in participants 6 to 10 years old than in all other ages combined (72.06 vs 99.64 mIU/mL, P = 0.038). In total, 7 (0.99%) subjects had quantifiable HBV DNA levels (280-18,820 IU/mL). Sequence analysis of the S gene revealed vaccine escape like mutations. Hepatitis B viremia can occur in completely vaccinated individuals who are negative for anti-HBc. Abbreviations: anti-HBc = antibody to hepatitis B core antigen, anti-HBs = antibody to hepatitis B surface antigen, AST = aspartate aminotransferase, COI = cutoff index, GMT = geometric mean titers, HBeAg = hepatitis B e antigen, HBsAg = hepatitis B surface antigen, HBV = hepatitis B virus, OBI = occult hepatitis B infection, PCR = polymerase chain reaction.

Şehrengiz Tarih ve Kültür Dergisi, XV/146 (Mart-Nisan 2024), s. 6-27

Osmanlı Taḳvīm ve Tārīḫ literatüründe Kuruluş devri Sultanlarının saltanat vârisi şehzâdelerine verdikleri yüksek makamlar ve yaptıkları önemli atamaların târihleri, Sultân’ın ölümü üzerine tahta geçmesi beklenen şehzâdelerin siyasî ve askerî kariyerlerinde büyük izler bırakan önemli birer dönüm noktası oldukları için, akıllarda doğrudan onların “Cülūs” tarihleri şeklinde kalmış ve erken Osmanlı kronikleri ile Tāriḫī Taḳvīm’lerde ilk bakışta çelişkili birer veri gibi gözüken, çağdaş târihî kanıtlar ışığında henüz şimdi çözümlenen birbirinden bağımsız farklı târihlerin ortaya çıkmasına zemin hazırlamıştır. Osman Gâzî ve Orhan Gâzî’den sonra, emâret ve cülûs târihleri hakkında kaynaklarda farklı rivâyetler ve kronolojik veriler bulunan kuruluş devri sultanlarının son örneği, Orhan Gâzî’nin henüz kendi sağlığında Rumeli ordular komutanlığına atadığını ve saltanat tahtına vâris kıldığını bir önceki bölümde uzun uzadıya gösterdiğimiz üçüncü Osmanlı pâdişâhı Sultan Murâd Hüdâvendigâr’dır. Dedesi ve babası gibi onun da emâretinin hangi zaman aralığında başladığı bugüne kadar tam olarak tespit edilemediği gibi; kesin cülûs târihi de babasının daha önce belirtilen ölüm târihi olmakla birlikte, bu cülûsun hangi şartlar altında ve nasıl gerçekleştiği meselesi de târihçiler arasında tam anlamıyla açıklığa kavuşturulabilmiş değildir. Ayrıca onun ölüm târihinin Kosova Savaşı’nın gerçekleştiği 17 Cemâziye’l-âhir 791 / 15 Haziran 1389 günü olduğu bilinmekle berâber; tıpkı Edirne’nin fetih târihi gibi, saltanat zamânı ve Rumeli’deki fütûhâtının önemli bir kısmı üzerinde de hâlâ bilgi ve kronoloji boşlukları bulunduğu, bâzı modern araştırmacıların tenkidî tespitlerine rağmen kimi noktaların hâlâ belirsizliğini koruduğu, hattâ büyük oğlu Şehzâde Bâyezîd’in emâret ve cülûs târihlerine yönelik karmaşık veriler nedeniyle ölüm târihi hakkında bile bilinen asıl târihle çelişen başkaca târihler bulunduğu dikkati çekmektedir. İşte bu karışık noktalar da, bir kısmı henüz yeni ortaya çıkmış olan farklı çağdaş kaynak ve belgeler ışığında çözüme kavuşturularak, İlk Osmanlı Sultanlarının emâret, cülûs ve ölüm târihlerindeki problemlerin çözümü meselesi; son olarak Murad Hüdâvendigâr dönemindeki sapma ve karışma noktalarının da sebeplerine ve aslî kökenlerine inilip kesin bir sonuca bağlanarak mütemmim bir hâle getirilecektir. Murad Hüdâvendigâr’ın şehâdeti ve oğlu Yıldırım’ın cülûsundan sonra tahta çıkan diğer Osmanlı sultanlarının emâret, cülûs ve ölüm târihlerinin kronolojisinde herhangi problem ve karışıklık söz konusu olmayıp; ‘Osman Gâzî’den Sultan I. Murad’ın ölümüne kadarki süreçte dikkati çeken ve ilk bakışta çelişkili birer veri gibi gözüken bağımsız târihler silsilesinin ise, burada ortaya koyduğumuz bilimsel tespit ve çözümlemeler ışığında yeniden anlamlandırılıp, nitelikli ve kapsamlı bir şekilde tashih edilmesi gerekir.