Hepatitis Monthly
Volume:4 Issue: 5, Autumn 2004

Occult hepatitis B virus (HBV) infection is characterized by presence of HBV infection with undetectable hepatitis B surface antigen (HBsAg). Diagnosis of occult HBV infection requires sensitive HBV-DNA PCR assay. Recently it has been shown that occult hepatitis B may be a cause of cryptogenic liver disease. The aim of this study is the investigation of occult HBV infection among patients with cryptogenic liver disease. 65 consecutive paraffin-embedded liver tissues from cases referred to RCGLD (Research Center for Gastroenterology and Liver Diseases) and THC (Tehran Hepatitis Center) during the years 2001 and 2002 for liver biopsy because of elevation of alanine aminotransferase (ALT) levels for more than six months were studied. Among these, 12 patients with cryptogenic liver disease were found. Human tissue DNA could be extracted in 7 of 12 patients. In these patients liver biopsies were reviewed and HBV-DNA and HBsAg and HBcAg were assayed in liver tissue by polymerase chain reaction (PCR) and immunohistochemistry (IHC), respectively. Histologically, chronic hepatitis, cirrhosis and nonspecific changes were reported. HBVDNA was detectable in 4 patients but IHC was negative in all. The frequency of occult HBV infection was more than 50%. Occult HBV infection is common among patients with cryptogenic liver disease. In these patients, HBV-DNA may be detected more frequently among patients with more advanced liver pathology (cirrhosis) and more aggressive clinical course (decompensated cirrhosis).

Hepatitis B virus is one of the most common chronic infections in the world. Over half of the world population has been exposed to this virus. It is estimated that 3% of Iranian population are chronic carriers. To determine the seroprevalence of hepatitis B infection in pregnant women in Zahedan, Iran. In this cross-sectional study in a period of one month in Zahedan, total cases of 200 pregnant women were enrolled in our study. Sera obtained from these pregnant women were evaluated for HBsAg by ELISA method. Our data showed that 6.5% of the pregnant women had a positive test for HBsAg. It seems that hepatitis B infection is highly endemic at least in pregnant women in Zahedan. On the basis of these epidemiologic data, screening of all pregnant women is necessary.

In patients with chronic hepatitis B and compensated liver disease, lamivudine reduces serum HBV-DNA to undetectable levels within 1 to 2 months of treatment. The aim of this study was to evaluate the efficacy of lamivudine in cases with hepatitis B _ related cirrhosis. This is a quasi-experimental study on 90 patients with cirrhosis due to hepatitis B. All patients received lamivudine at a dose of 100 mg per day, given orally for 52 weeks. The effect of the drug on liver function, viremia and clinical stage of the disease were assessed. Mean age of patients was 53.2 +- 1.43 years. After 24 weeks and 52 weeks, there were only 28.6% and 26.4% of cases with positive HBV-DNA. Child score had a significant decrease after one year treatment with lamivudine. This study presents a sufficient antiviral effect of lamivudine (Biovudine) in HBV-related cirrhosis patients.