Occult hepatitis B: the Egyptian situation

Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt.
Tropical gastroenterology: official journal of the Digestive Diseases Foundation 12/2012; DOI: 10.7869/tg.2012.65

ABSTRACT Occult hepatitis B infection is defined as the presence of HBV DNA in serum and/or the liver
tissue without detectable HBsAg with or without anti-HBc or anti-HBs antibodies. In Egypt
many studies on occult hepatitis B have been conducted and this infection is well established
in various patients groups. This short review sheds light on the occurrence of occult hepatitis
B infection among different disease states in Egypt. The coexistence of occult hepatitis B with
hepatitis C infection is of particular importance because of its added co-morbidity of liver
enzymes elevation, increased severity of liver disease and increased risk of hepatocellular
carcinoma. Patients on regular hemodialysis and those exposed to blood transfusion are at
high risk of acquiring this form of infection. The highest prevalence of occult hepatitis B virus
in Egypt was reported among patients with hepatocellular carcinoma and similar to the scenario
for classic hepatitis B infection, genotype D is the most prevalent genotype.

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Available from: Mohamed H Emara, Jul 05, 2015
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    ABSTRACT: Hepatitis B and C are, and will remain for some time, major health problems in Egypt and the entire continent of Africa. Both infections can lead to an acute or silent course of liver disease, progressing from liver impairment to cirrhosis and decompensated liver failure or hepatocellular carcinoma (HCC) in a 20-30 year period. In addition, hepatitis B and C infection rates differ in different settings, and prognosis may be worse in conjunction with schistosomiasis in Egypt, malaria in Sudan and human immunodeficiency virus (HIV) in other African populations. Unlike hepatitis B virus (HBV), for which the prospects for controlling the spread of infection by vaccination are promising, prospects for development of an effective vaccine against hepatitis C virus (HCV) are limited. As well as screening of blood for transfusion and using sterile needles for injection, preventive measures should be undertaken to reduce the risk of contact (often described as community-acquired infection). Until more is known about the unidentified routes of transmission in tropical and subtropical settings it will be difficult to be specific about the kind of measures which may be effective. Success may largely depend on changing habits within the population. Prevention should be the main goal of current efforts until low-cost, effective therapies become available.
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