Persistent hepatitis B virus infection in subjects without hepatitis B surface antigen: Clinically significant or purely “occult”?

By C. Bréchot, V. Thiers, D. Kremsdorf, B. Nalpas, S. Pol, P. Paterlini-Bréchot. Hepatology, 2001

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iArc monogrAphs on the evAluAtion oF cArcinogenic risks to humAns (2012, background): “The prevalence of seropositivity of HBV DNA in HBsAg-seronegative subjects is in the range of 0–10% among those without liver disease, 11–19% in patients affected with chronic hepatitis, and 12–61% in HCC patients (Bréchot et al., 2001; Chen, 2005).”
Global Epidemiology of Hepatitis B Virus (2004, background): “HBsAg negative persons may include those never infected and those who have been infected and fully cleared the infection; additionally, some individuals may spontaneously lose HBsAg but remain chronically infected.(80,81) Similarly, anti-HBc tests suffer from relatively poor specificity and false po”
Occult hepatitis B virus infection. (2007, background): “However, much evidence indicates that the genomic heterogeneity of the virus does not account for the occult status in the majority of the cases [18–20].”
Statements from the Taormina expert meeting on occult hepatitis B virus infection. (2008, background): “HBV DNA may also be integrated in the OBI host’s genome [4,14].”
EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. (2012, background): “However, chronic HBV infection cannot be completely eradicated due to the persistence of covalently closed circular DNA (cccDNA) in the nucleus of infected hepatocytes, which may explain HBV reactivation [26,55,56].”