未抗病毒治疗人类免疫缺陷病毒感染者隐匿性乙型肝炎的调查及其临床特点

目的 观察未经抗病毒治疗(ART)的人类免疫缺陷病毒(HIV)感染者和普通人群隐匿性乙型肝炎流行状况,评估HIV感染者合并隐匿性乙型肝炎的临床特点.方法 通过酶联免疫分析法检测未经ART治疗的HIV感染者和普通人群血浆HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc水平,筛查出HBsAg阴性的HIV感染者(感染组)249例,健康体检者HBsAg阴性者121例(健康组),再采用罗氏COBASAmpliPrep/COBAS TaqManHBVTest,version2.0试剂盒检测外周血HBV DNA水平.统计分析用STATA 10软件处理本实验各组数据.用Fisher's精确概率检验、秩和检验.结果 感染组HBV DNA阳性者24例,隐匿性乙型肝炎占9.7％;健康组HBV DNA阳性者4例,隐匿性乙型肝炎占3.3％,两组比较,P=0.035,差异有统计学意义.感染组24例HBVDNA阳性者,HBV DNA载量最低者血中能测到,但在检测值水平以下,(即＜20 IU/ml),最高者3.22×105 IU/ml.大于100 IU/ml占37.5％(9/24),20 ～ 99 IU/ml占16.7％ (4/24),＜20IU/ml,但可测出HBV DNA占45.8％ (11/24).HIV感染者抗-HBc(+)/抗-HBs(+)组、抗-HBc(+)/抗-HBs(-)组、抗-HBc(-)/抗-HBs(+)组、抗-HBc(-)/抗-HBs(-)组DNA阳性率分别为7.3％ (8/110),20.8％ (11/53),14.3％ (3/21),3.1％(2/64),抗-HBc(+)/抗-HBs(-)组分别与抗-HBc(+)/抗-HBs(+)组、抗-HBc(-)/抗-HBs(-)组两组比较,P值分别为0.018和0.003,差异有统计学意义.四组间HBV DNA病毒载量比较,P=0.805,差异无统计学意义.感染组HBV DNA(+)组与HBV DNA(-)组比较,CD4计数(Z=1.902,P=0.0586)和ALT水平(Z=1.401,P=0.1611)差异无统计学意义.结论 在未经ART治疗HIV感染者中,隐匿性乙型肝炎高于普通人群,HIV感染者抗-HBc(+)/抗-HBs(-)组隐匿性乙型肝炎最高.     

唐山地区献血人群隐匿性乙型肝炎病毒感染分析

目的了解唐山地区无偿献血人群隐匿性乙型肝炎感染情况。方法用ELISA法检测无偿献血者的乙型肝炎血清标志物,对于HBsAg阴性样本,进行HBV核酸检测（NAT）,NAT阳性样本,用罗氏试剂确证HBV DNA载量。结果共检测116 741例血样,证实隐匿性乙型肝炎感染者35例,占总献血人数的0.29‰。其中97.1%隐匿性乙型肝炎感染者样本的HBV DNA滴度低于102IU/ml。在HBV DNA阳性人群中,抗-HBc阳性率较高,占81.5%,抗-HBs阳性或乙型肝炎病毒血清标志物全阴性也可检出HBV DNA分别占55.6%和22.9%。结论唐山地区献血人群中血清HBsAg阴性者存在一定比例的隐匿性HBV感染,其HBV病毒载量均较低,核酸检测能够提高HBV感染的检出率。     

人类免疫缺陷病毒感染者合并隐匿性乙型肝炎病毒感染的现状调查

目的 调查分析上海地区HIV感染者中隐匿性HBV感染的流行现状.方法 对上海市公共卫生临床中心就诊的HIV感染者在尚未接受抗病毒治疗前采集血标本,检测HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc,抗-HCV,CD4+T细胞计数,使用巢式PCR法检测HBV S区.结果 105例(男92例,女13例)HBsAg阴性的HIV感染者中32例(男27例,女5例)HBV DNA阳性;16～30岁年龄组22例,其中5例HBV DNA阳性,31～49岁年龄组44例,其中15例HBV DNA阳性,50～75岁年龄组39例,其中12例HBV DNA阳性;32例中有27例至少一项HBV血清学标志物阳性,5例均阴性.47例合并HCV感染者中有14例HBV DNA阳性,阳性率29.8%;58例未合并HCV感染的HIV感染者中18例HBV DNA阳性,阳性率为31.0%.CD4+T细胞计数平均值145.1个/μ(4～623个/μ1),75例CD4+T细胞<200个/μ1的患者中有26例HBV DNA阳性,约占34.7%,30例CD4+T细胞>200/μ1患者中有6例HBV DNA阳性,阳性率为20.0%.以上各项之间两两相比差异均无统计学意义.结论 HIV感染者中存在隐匿性HBV感染,且与HIV感染者性别、年龄、HBV标志物、是否合并HCV感染及CD4+T细胞计数无明显相关.     

献血员隐匿性乙型肝炎病毒感染的分子流行病学

目的 了解献血员中隐匿性HBV感染的发生率,从S基因变异角度探讨隐匿性HBV感染可能的分子机制.方法 收集经血站筛查HBsAg阴性的合格献血员血浆594份,ELISA法检测HBV血清学标志物,套式PCR检测血清HBV DNA.对筛查出的隐匿性HBV感染者再次用雅培试剂定量检测HBV血清学标志物,并对其S区进行测序,发现可能与HBV隐匿性感染有关的变异位点.随机收集11例HBsAg阳性的HBV感染者作为阳性对照,对其S区进行测序,比较其与隐匿性HBV感染之间的关系.结果 在594例献血员中有15例为隐匿性HBV感染,隐匿性HBV感染的发生率为2.5％.未发现HBV血清学标志物检测结果与隐匿性HBV感染有相关性.15例隐匿性HBV感染者中有10例进行了S区测序,结果HBV均有不同程度的变异,其中3例在“a”决定簇内出现氨基酸突变,分别为1126T(1例)、T140I(2例).与隐匿性HBV感染者相比,阳性对照在“a”决定簇内仅出现了1例T131N变异.结论 常规检测HBsAg阴性的献血员中存在隐匿性HBV感染,且这些病毒可能存在变异.     

40岁以上HBeAg阳性和阴性慢性乙型肝炎病毒感染者的临床特点比较

目的探讨40岁以上HBeAg阳性和HBeAg阴性慢性HBV感染者的临床特点。方法收集40岁以上慢性HBV感染者共186例,其中HBeAg阳性组93例,HBeAg阴性组93例。结果 40岁以上HBeAg阳性慢性HBV感染者男性为多(76.34%),并且多有乙型肝炎家族聚集现象(78.49%);40岁以上HBeAg阳性慢性HBV感染者的HBV DNA水平与ALT水平均高于HBeAg阴性慢性HBV感染者;40岁以上乙型肝炎肝硬化患者中,HBeAg阳性者占少数;40岁以上乙型肝炎肝硬化失代偿期患者中,HBeAg阳性者多合并腹水形成,而HBeAg阴性者既可见腹水形成,又可见上消化道出血。结论 40岁以上HBeAg阳性慢性HBV感染者多见于男性,多具有家族聚集现象,HBeAg阳性肝硬化患者所占比率较低,但HBV DNA水平较高,肝脏的炎症活动明显,病情进展可能较快。     

HBsAg阴性或抗-HBc阳性者肺癌术后辅助化学治疗中乙型肝炎病毒的再激活

目的 探讨HBsAg阴性或抗-HBc阳性者肺癌术后辅助化学治疗中HBV的再激活及其相关危险因素.方法 回顾性分析2003年1月到2011年12月接受辅助化学治疗的3280例肺癌术后患者,所有入组患者进行HBV血清学标志物和生物化学检测,并接受以顺铂为基础的辅助化学治疗方案.数据比较行x2检验.结果 367例HBsAg阴性或抗-HBc阳性肺癌术后患者中,14例(3.81％)进展为乙型肝炎.单因素分析表明,患者年龄≥70岁(x2=13.003,P=0.019)、肝脏CT检查为脂肪肝或早期肝硬化(x2=11.225,P=0.026)和使用糖皮质激素累计剂量超过150mg(x2=7.008,P=0.033)是辅助化学治疗中HBV再激活的相关因素;而性别、基础辅助化学治疗方案与HBV的再激活无关联.结论 肺癌术后的辅助化学治疗中,HBsAg阴性或抗-HBc阳性者有一定比例可以发生HBV的再激活.     

HBsAg与抗-HBs同时阳性的慢性乙型肝炎患者临床特点分析

目的分析HBsAg与抗-HBs同时阳性的现象及其临床特点,并探讨其产生的原因。方法收集2011年2月-2014年2月东南大学附属第二医院体检者2260例,其中被诊断为慢性乙型肝炎的患者830例。采用化学发光微粒子免疫分析法筛选HBsAg与抗-HBs同时阳性的患者188例,分为HBeAg阳性组(n=101)和HBeAg阴性组(n=87)。同时选取200例HBsAg阳性、抗-HBs阴性者作为对照,其中HBeAg阳性组80例,HBeAg阴性组120例。检测HBV血清学标志物、肝功能、病毒载量并结合临床进行分析。计数资料组间比较采用χ2检验。结果 HBV血清学标志物在HBsAg与抗-HBs双阳性情况下共有5种模式,其中以HBsAg、抗-HBs、HBeAg及抗-HBc阳性,且抗-HBe阴性多见,占47.9%(90/188),肝功能指标总异常率为69.1%(130/188),HBV DNA总阳性率为56.9%(107/188)。HBeAg阳性的2组HBV DNA均存在高水平复制,其中HBsAg与抗-HBs双阳性组HBV DNA阳性率与对照组比较,差异无统计学意义(χ2=2.632,P0.05);HBeAg阴性组中,HBsAg与抗-HBs双阳性组HBV DNA定量1×105IU/ml的比例与对照组比较,差异有统计学意义(χ2=10.740,P0.05)。对HBV S区进行测序分析发现,测序的80例HBsAg与抗-HBs双阳性患者中有27例患者的HBV S区发生变异,突变率33.7%,且S区变异位点主要有P29L、S61L、P62L、I126T/S、Q129N、M133K、F134L、G145R/K、L175S和L186H等。结论 HBsAg与抗-HBs同时阳性者在乙型肝炎患者中有一定比例,其主要原因可能是病毒株变异所致。这种情况并不代表疾病好转,且抗-HBs出现并不一定能完全有效清除HBsAg,病毒DNA往往存在持续复制,需引起重视。     

血液透析患者中隐匿性乙型肝炎病毒感染的分子流行病学分析

血清HBsAg阴性,而血清或肝脏组织HBV DNA阳性被定义为隐匿性HBV感染.透析患者其自身免疫功能低下,且长期反复接受动静脉穿刺等原因,致其成为HBV感染的高危人群.在欧美地区的医疗机构里,透析单元中HBV的传播仍远大于内、外科病房及门诊,其HBsAg阴性的维持性血液透析患者隐匿性HBV感染的发生率为0.9%～12.4%[1-2].而国内鲜见相关报道.     

无偿献血人群隐匿性乙型肝炎病毒感染调查

目的 调查无偿献血人群隐匿性乙型肝炎病毒感染(OBI)情况。方法 2021年1月～2021年12月我站无偿献血者血液样本107397份,采用两种ELISA法检测试剂盒进行HBsAg的初次筛查,采用核酸检测(NAT)法对两次HBsAg结果均为阴性的样本进行HBV DNA检测。对血清HBsAg阴性而HBV DNA阳性样本进行HBV血清学标志物检测,并采用实时荧光定量聚合酶链式反应(PCR)法检测核酸和病毒基因分型。结果 在筛查的107397例无偿献血人群血样本中,经血清标志物检测后确认为OBI者29例(0.27‰);血清抗-HBc阳性者12例(35.3%),抗-HBe/抗-HBc阳性者8例(23.5%),抗-HBs/抗-HBc阳性者6例(17.7%),抗-HBs/抗-HBe/抗-HBc阳性者3例(8.8%);19～29岁年龄段献血人群OBI感染率为0.09‰,30～39岁人群为0.32‰,40～49岁人群为0.39‰,50～55岁年龄段献血人群OBI感染率为0.41‰,且该年龄段重复献血者OBI感染率为0.31‰;血清抗-HBs/抗-HBc阳性和抗-HBs/抗-HBe/抗-HBc OBI献...     

丙氨酸转氨酶持续正常的HBeAg阴性慢性乙型肝炎病毒感染者肝脏组织学改变及其影响因素

目的 分析ALT持续正常的HBeAg阴性慢性HBV感染者的肝脏组织学改变及其影响因素.方法 选择2003年10月至2008年3月经皮肝组织活检的ALT持续正常的HBeAg阴性慢性HBV感染者98例,检测其ALT水平、HBV标志物、HBV DNA水平和肝脏组织学改变.均数比较采用t检验和单因素方差分析,非参数统计采用Mann-Whitney U检验和Kruskal-Wallis检验.采用Logistic模型进行独立危险因素分析,采用受试者工作特征曲线评价ALT水平对显著肝脏病理改变的诊断价值.结果 98例患者中炎症活动指数(Hal)≥4、纤维化(F)评分≥3的患者分别占22.4%与17.3%.ALT为(0.51～1.00)×正常值上限(ULN)组发生上述病理改变的比例均高于(0～0.50)×ULN组(HAI≥4:36.4%比11.1%,χ2=8.881,P=0.003;F评分≥3:27.3%比9.3%,χ2=5.487,P=0.019).年龄每增长10岁是HAI≥4分的独立危险因素(OR=2.410,P=0.023);年龄>45岁者发生HAI≥4分的比例明显高于≤45岁者(33.3%比13.4%,χ2=4.923,P=0.027).HBV DNA＜1×104拷贝/mL时,仍有14.9%的患者Hal≥4分、12.8%的患者F评分≥3分.结论 部分ALT持续正常的HBeAg阴性慢性HBV感染者在不同HBV DNA水平存在一定程度的肝脏病理改变,肝组织活检对于年龄＞45岁的患者是十分重要的.0.50×ULN有望为中国HBeAg阴性的慢性HBV感染者的临床处理提供一个恰当的ALT"正常"参考值.     

Occult hepatitis C virus infection is more common than hepatitis B infection in maintenance hemodialysis patients

Patients of end stage renal disease on maintenance hemodialysis were enrolled to study the prevalence of occult and dual hepatitis B virus （HBV） and hepatitis C virus （HCV） infection and non-occult hepatitis B and C virus infection. One hundred and two patients were enrolled. Thirty patients had HCV infection, three of them were positive in anti-HCV. So, 27 （90%） of HCV-positive patients had occult HCV infection. Eleven （11%） patients had HBV infection. Five patients were positive in anti-HBc or HBV-DNA, but negative in HBsAg （occult HBV infection）. Three （3%） patients had dual HBV and HCV infection. None of the patients showed changes in viral markers during the follow-up of 8 mo on average （1-12 mo）.     

Role of occult hepatitis B virus in chronic hepatitis C patients with flare of liver enzymes

Background

Occult HBV infection is defined by detection of HBV DNA in the serum or liver tissue of patients who test negative for HBsAg. The prevalence of occult HBV is higher in hepatitis C virus (HCV) positive patients than HCV negative patients and may have an impact on their clinical outcome. In this study, we evaluated the role of occult hepatitis B virus infection in chronic hepatitis C patients with ALT flare.

Methods

Sixty HBsAg negative patients with chronic hepatitis C virus infection were included. Patients were divided into 2 groups according to their ALT level: 30 patients with normal or slightly high ALT and 30 patients with ALT flare (≥ 5 times normal values). Patients in both groups were examined for the detection of anti-HBs, anti-HBc IgM, and anti-HBc IgG. HBV DNA was detected using semi-nested PCR technique.

Results

In patients with normal or slightly high ALT, HBV DNA was detected in 4 (13.3%) patients, while in those with ALT flare, HBV DNA was detected in 19 (63.3%) patients (p < 0.001). No association was found between the presence of HBV DNA and various serology markers of HBV infection.

Conclusion

Presence of occult hepatitis B, with its added deleterious effect, must always be considered in chronic hepatitis C patients especially those with flare in liver enzymes; HBsAg should not be used alone for the diagnosis of HBV infection.     

隐匿性乙型肝炎病毒感染者临床特点和肝组织病理学检查

目的了解血清肝炎病毒标志物阴性、肝功能反复异常患者中HBV隐匿性感染的比例及其临床和病理学特点。方法对27例血清肝炎病毒标志物阴性、肝功能反复异常患者采用免疫组化法检测肝组织HBsAg、HBcAg和HCVAg，并进行常规的病理学检查。结果肝组织HBsAg和（或）HBcAg阳性9例（33．3％）；HBsAg和（或）HBcAg及HCVAg阳性10例（37．0％）；全阴性8例（29．6％）。在HBV隐匿性感染的19例患者中，慢性肝炎8例，肝硬化11例。结论HBV和HCV感染为血清肝炎病毒标志物阴性患者肝功能反复异常的主要原因之一，尤其是HBV感染。这种HBV隐匿性感染与慢性肝炎、肝硬化的发生关系密切，应引起重视。     

Isolated antibody to hepatitis B core antigen in patients with chronic hepatitis C virus infection

AIM: To evaluate the prevalence of isolated anti-HBc in patients with chronic hepatitis C virus (HCV) infection, and its relation to disease severity. METHODS: We screened all patients with chronic HCV infection referred to King Faisal Specialist Hospital and Research Center for hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs), and anti-HBc. One hundred and sixty nine patients who tested negative for both HBsAg and anti-HBs were included in this study. RESULTS: Pathologically, 59 had biopsy-proven cirrhosis and 110 had chronic active hepatitis (CAH). Of these 169 patients, 85 (50.3%) tested positive for anti-HBc. Patients with CAH had significantly higher prevalence of isolated anti-HBc than patients with cirrhosis, 71 (64.5%) and 14 (23.7%) respectively (P < 0.001). Twenty-five patients were tested for HBV DNA by qualitative PCR. The test was positive in 3 of them (12%; occult HBV infection). CONCLUSION: Isolated anti-HBc alone is common in Saudi patients with chronic HCV infection, and is significantly more common in those with CAH than those with cirrhosis. Therefore, a screening strategy that only tests for HBsAg and anti-HBs in these patients will miss a large number of individuals with isolated anti-HBc, who may be potentially infectious.     

A mutation of the start codon in the X region of hepatitis B virus DNA in a patient with non-B, non-C chronic hepatitis

There are cases of hepatitis involving occult hepatitis B virus(HBV)infection in which,even though the HB surface antigen(HBsAg)is negative,HBV-DNA is detected by a polymerase chain reaction(PCR).We con-ducted a sequence analysis of the entire HBV region in a case of non-B non-C chronic hepatitis in a 46-yearold female.A diagnosis of non-B non-C chronic hepatitis was made.Although HBV markers,such as HBs antibody(anti-HBs),anti-HBc,HBeAg and anti-HBe,were negative,HBV-DNA was positive.Nested PCR was performed to amplify the precore region of HBV-DNA and all remaining regions by long nested PCR.Sequence analysis of the two obtained bands was conducted by direct sequencing.Compared with the control strains,the ATG(Methionine)start codon in the X region had mut ated to GTG(Valine).It is assumed that a mutation at the start codon in the X region may be the reason why HBV markers are negative in some cases of hepatitis that involve occult HBV infection.     

Previous hepatitis B virus infection is associated with worse disease stage and occult hepatitis B virus infection has low prevalence and pathogenicity in hepatitis C virus‐positive patients

Abstract: Background: Anti‐hepatitis C virus (anti‐HCV) patients with chronic liver disease (CLD) frequently show markers of previous hepatitis B virus (HBV) infection. Moreover, they may carry occult HBV infection. These features might influence clinical and biochemical features as well as stage of disease. Aim: To assess the prevalence and clinical associations of previous (positivity for anti‐HBs and/or anti‐HBc antibodies) and occult HBV infection (positivity for HBV‐DNA by nested‐PCR) in the serum of anti‐HCV‐positive, HCV‐RNA‐positive, HBsAg‐negative patients with various degrees of CLD seen at a tertiary referral centre. Patients: A total of 119 patients fulfilled the inclusion criteria (84 chronic hepatitis and 35 liver cirrhosis). Results: Forty‐eight patients (40.3%) showed markers of previous HBV infection. This feature was more frequent (P = 0.02) among cirrhotics (57%) as compared to chronic hepatitis patients (33%). Chronic hepatitis patients positive for markers of previous HBV infection had worse histology as compared to negative ones (grading: 6.4 ± 2.7 versus 4.6 ± 3.0, P = 0.004; staging: 1.6 ± 1.2 versus 1.0 ± 1.0, P = 0.01). Eight patients were positive for HBV‐DNA in serum (6.7%). No difference in the presence of occult HBV infection was seen between various degrees of liver disease (7.1% of chronic hepatitis, 5.7% of cirrhosis) and among patients who were positive (10.4%) or negative (4.2%) for markers of previous HBV infection. No significant biochemical, virological, or histological difference was observed between age, age at infection, duration of infection, marker patterns of previous HBV infection‐matched HBV‐DNA‐positive and negative chronic hepatitis patients. Conclusions: Our findings suggest that previous HBV infection among anti‐HCV patients is associated with worse disease stage. In these patients, the prevalence of occult HBV infection is low and there is no difference in distribution among patients with or without markers of previous HBV infection. Furthermore, it does not seem to be associated with disease stage. Lastly, at least among patients with chronic hepatitis, it does not seem to affect the severity of disease.     

Prevalence and time course of hepatitis B virus infection in patients with systemic lupus erythematosus under immunosuppressive therapy

Objective

To clarify the prevalence and time course of hepatitis B virus (HBV) infection in patients with systemic lupus erythematosus under immunosuppressive therapy.

Methods

We performed serological examination of 248 lupus patients to determine the presence of HBV, including hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core antibody (anti-HBc). Serum HBV DNA levels were measured in HBsAg-positive patients or resolved HBV carriers (HBsAg-negative, anti-HBs-positive, and/or anti-HBc-positive). If possible, we repeatedly performed examination of markers of HBV infection in resolved carriers.

Results

Two (0.8 %) patients were positive for HBsAg. Among 41 (16.5 %) patients who were considered as resolved HBV carriers, 1 (2.4 %) showed serum HBV DNA, which indicated occult HBV infection. The mean age and positive rate of anti-double stranded DNA antibody were significantly higher in resolved carriers than in anti-HBs- and anti-HBc-negative patients. Repeated examination showed that the anti-HBs and anti-HBc titer decreased below the threshold in 4 resolved carriers.

Conclusions

The prevalence of resolved HBV carriers in Japanese lupus patients was 16.5 %. Among them, occult HBV infection and decrease in anti-HBs and anti-HBc titer were observed. These findings indicated that all lupus patients should undergo serological examination for HBV before treatment. If patients have already been treated, we must carefully monitor their liver function, even when all HBV markers are negative.     

Hepatitis B virus reactivation and alemtuzumab therapy

Reactivation of hepatitis B virus infection in subjects receiving cytotoxic treatment for heamatological malignancies occurs in 21-53% of chronic HBsAg carriers and in an unknown number of HBsAg negative subjects harbouring occult HBV infection. Immunotherapy with alemtuzumab, a humanized monoclonal antibody against CD52 epitopes on lymphocytes cells produces deep immunosuppression. We describe two subjects with chronic lymphocytic leukaemia and occult HBV infection who developed a virological and biochemical flare of hepatitis B following immunotherapy with alemtuzumab. One of them developed full blown hepatitis with seroreversion from anti-HBs to HBsAg after four weeks of alemtuzumab therapy. Lamivudine (100 mg die) achieved a complete clinical recovery and HBV-DNA clearance from blood within 8 weeks. The second patient (HBsAg and HBV-DNA seronegative, anti-HBs and anti-HBc positive before treatment) was kept under prophylaxis with lamivudine up to three months after alemtuzumab. Two months after withdrawal of lamivudine, clinical and laboratory features of acute hepatitis B developed. Lamivudine therapy was restarted and a prompt recovery was obtained with HBsAg and HBV-DNA clearance.     

Antibody to hepatitis B core antigen as a screening test for occult hepatitis B virus infection in Egyptian chronic hepatitis C patients

Purpose  The presence of hepatitis B virus (HBV) DNA in liver tissue and/or in serum in the absence of detectable hepatitis B surface antigen (HBsAg) is called occult HBV infection. This pattern was identified in patients with chronic hepatitis C virus (HCV) infection. The aim of this study was to determine the role of antibodies to hepatitis B core antigen (anti-HBc) as a screening test for occult HBV infection in Egyptian chronic HCV patients. Methods  One hundred chronic HCV patients negative for HBsAg were included and subdivided into two groups according to anti-HBc-IgG seroreactivity. Group A included 71 patients positive for anti-HBc (53 men and 18 women, mean age ± SD 48.8 ± 9.6 years), and group B included 29 patients negative for anti-HBc (18 men and 11 women, mean age ± SD 46.6 ± 11.7 years). All patients were subjected to full clinical assessment, routine laboratory investigations, abdominal ultrasonography and quantification of HBV-DNA by real-time PCR. Results  Chronic HCV patients positive for anti-HBc have more severe liver disease compared with anti-HBc negative patients. Although HBV-DNA in the serum was detected in 22.5% of anti-HBc-positive chronic HCV patients, it was not detected in any of anti-HBc-negative chronic HCV patients. There was no significant difference in any of the clinical and laboratory data tested between anti-HBc-positive patients with and without HBV-DNA in the serum. Conclusion  A significant number of patients with anti-HBc had detectable levels of HBV-DNA in the serum. Egyptian chronic HCV patients have a high prevalence of occult HBV infection.