• 1.

    Yuen M-F, Chen D-S, Dusheiko GM, Janssen HLA, Lau DTY, Locarnini SA, Peters MG, Lai C-L, 2018. Hepatitis B virus infection. Nat Rev Dis Primers 4: 18035.

  • 2.

    Yip TC, Wong GL, 2019. Current knowledge of occult hepatitis B infection and clinical implications. Semin Liver Dis 39: 249260.

  • 3.

    Chen P, Xie Q, Lu X, Yu C, Xu K, Ruan B, Cao H, Gao H, Li L, 2017. Serum HBeAg and HBV DNA levels are not always proportional and only high levels of HBeAg most likely correlate with high levels of HBV DNA: a community-based study. Medicine (Baltimore) 96: e7766.

    • Search Google Scholar
    • Export Citation
  • 4.

    Alborzi AM, Kiani Ghalesardi O, Bamdad T, Pourfathollah AA, Jalalifar MA, Shahjahani M, Kazemi Arababadi M, Dehghani Fard A, Saki N, 2013. Occult hepatitis B infection and its role in blood safety: a review. Iran J Blood Cancer 5: 6175.

    • Search Google Scholar
    • Export Citation
  • 5.

    Shaker O, Ahmed A, Abdel Satar I, El Ahl H, Shousha W, Doss W, 2012. Occult hepatitis B in Egyptian thalassemic children. J Infect Dev Ctries 6: 340346.

    • Search Google Scholar
    • Export Citation
  • 6.

    Singh H, Pradhan M, Singh RL, Phadke S, Naik SR, Aggarwal R, Naik S, 2003. High frequency of hepatitis B virus infection in patients with β-thalassemia receiving multiple transfusions. Vox Sang 84: 292299.

    • Search Google Scholar
    • Export Citation
  • 7.

    El Sheredy AG, Mahmoud OA, El Ghazzawy EF, Helaly GF, El Naggar AA, Mahadi MM, 2015. Occult hepatitis B virus infection in patients with blood diseases. Int J Curr Microbiol Appl Sci 4: 110.

    • Search Google Scholar
    • Export Citation
  • 8.

    Sofian M, Aghakhani A, Izadi N, Banifazl M, Kalantar E, Eslamifar A, Ramezani A, 2010. Lack of occult hepatitis B virus infection among blood donors with isolated hepatitis B core antibody living in an HBV low prevalence region of Iran. Int J Infect Dis 14: e308310.

    • Search Google Scholar
    • Export Citation
  • 9.

    Hu KQ, 2002. Occult hepatitis B virus infection and its clinical implications. J Viral Hepat 9: 243257.

  • 10.

    Raimondo G, Locarnini S, Pollicino T, Levrero M, Zoulim F, Lok AS, 2019. Update of the statements on biology and clinical impact of occult hepatitis B virus infection. J Hepatol 71: 397408.

    • Search Google Scholar
    • Export Citation
  • 11.

    Kwak MS, Kim YJ, 2014. Occult hepatitis B virus infection. World J Hepatol 6: 860869.

  • 12.

    Akram A, 2018. Occult hepatitis B virus infection: a review update. Bangladesh J Infect Dis 5: 32.

  • 13.

    Arababadi MK, Hassanshahi G, Yousefi H, Zarandi ER, Moradi M, Mahmoodi M, 2008. No detected hepatitis B virus-DNA in thalassemic patients infected by hepatitis C virus in Kerman province of Iran. Pakistan J Biologic Sci 11: 17381741.

    • Search Google Scholar
    • Export Citation
  • 14.

    Jonaidi-Jafari N, Rezaee-Zavareh MS, Tavallaei-Nosratabadi J, Ajudani R, Ramezani-Binabaj M, Karimi-Sari H, Izadi M, Ranjbar R, Miri SM, Alavian SM, 2017. Occult hepatitis B infection in hepatitis C patients with hematological disorders. Jundishapur J Microbiol 10: 7.

    • Search Google Scholar
    • Export Citation
  • 15.

    Allain JP, 2004. Occult hepatitis B virus infection: implications in transfusion. Vox Sang 86: 8391.

  • 16.

    Jenkins A, Minhas R, Morris C, Berry N, 2017. Complete genome sequence of the WHO international standard for hepatitis B virus DNA. Genome Announc 5: e01576e01516.

    • Search Google Scholar
    • Export Citation
  • 17.

    Origa R, 2016. β-Thalassemia. Genet Med 19: 609.

  • 18.

    Shah N, Mishra A, Chauhan D, Vora C, Shah N, 2010. Study on effectiveness of transfusion program in thalassemia major patients receiving multiple blood transfusions at a transfusion centre in western India. Asian J Transfus Sci 4: 9498.

    • Search Google Scholar
    • Export Citation
  • 19.

    Arababadi MK, Hassanshahi G, Pourfathollah AA, Zarandi ER, Kennedy D, 2011. Post-transfusion occult hepatitis B (OBI): a global challenge for blood recipients and health authorities. Hepat Mon 11: 714718.

    • Search Google Scholar
    • Export Citation
  • 20.

    Hajarizadeh B, Mesgarpour B, Nasiri MJ, Alavian SM, Merat S, Poustchi H, Malekzadeh R, Sedaghat A, Haghdoost AA, 2017. Estimating the prevalence of hepatitis B virus infection and exposure among general population in Iran. Hepat Mon 17: e11715.

    • Search Google Scholar
    • Export Citation
  • 21.

    Secil Bati N, Sait Tekerekoglu M, Duman Y, 2017. Investigation of HBV DNA in HBsAg positive patients. Med Sci (Turkey) 6: 1.

  • 22.

    Kuhns MC, Kleinman SH, McNamara AL, Rawal B, Glynn S, Busch MP, 2004. Lack of correlation between HBsAg and HBV DNA levels in blood donors who test positive for HBsAg and anti-HBc: implications for future HBV screening policy. Transfusion 44: 13321339.

    • Search Google Scholar
    • Export Citation
  • 23.

    Sharifi Z, Mahmoodian Shooshtari M, 2008. The relationship between HBSAG and HBV DNA in HBV-infected blood donors. Iran J Virol 2: 1316.

  • 24.

    Huzmeli C, Seker A, Candan F, Bağcı G, Akkaya L, Zahir Bakıcı M, Kayatas M, 2017. Occult hepatitis B prevalence in hepatitis B vaccinated dialysis patients. Turk Neph Dial Transpl 27: 5762.

    • Search Google Scholar
    • Export Citation
  • 25.

    Ranjbar M, Dadkhah M, Bokharaei Salim F, Daneshbodi M, Savaj S, Keyvani H, 2017. The prevalence of occult HBV infection among hemodialysis patients of Tehran, Iran. Mod Care J 14: e65546.

    • Search Google Scholar
    • Export Citation
  • 26.

    Muche M, Berg T, Rimpler S, Staedtler A, Böhm S, Nickel P, Baid-Agrawal S, 2019. Low prevalence of occult hepatitis B virus infection in chronic haemodialysis and kidney transplant patients. Liver Int 39: 263270.

    • Search Google Scholar
    • Export Citation
  • 27.

    Saijo T, Joki N, Inishi Y, Muto M, Saijo M, Hase H, 2015. Occult hepatitis B virus infection in hemodialysis patients in Japan. Ther Apher Dial 19: 125130.

    • Search Google Scholar
    • Export Citation
  • 28.

    Fabrizi F, Messa PG, Lunghi G, Aucella F, Bisegna S, Mangano S, Villa M, Barbisoni F, Rusconi E, Martin P, 2005. Occult hepatitis B virus infection in dialysis patients: a multicentre survey. Aliment Pharmacol Ther 21: 13411347.

    • Search Google Scholar
    • Export Citation
  • 29.

    Borhany M, Shamsi T, Boota S, Ali H, Tahir N, Naz A, Naseer I, Farzana T, Ansari S, Nadeem M, Zia Ur R, Sangji Z, 2011. Transfusion transmitted infections in patients with hemophilia of Karachi, Pakistan. Clin Applied Thromb Hemost 17: 651655.

    • Search Google Scholar
    • Export Citation
  • 30.

    Javanmard D, Namaei MH, Farahmand M, Ziaee A, Amini E, Ziaee M, 2019. Molecular and serological characterization of occult hepatitis B virus infection among patients with hemophilia. J Med Virol 91: 15191527.

    • Search Google Scholar
    • Export Citation
  • 31.

    Windyga J, Brojer E, Gronowska A, Grabarczyk P, Mikulska K, Szczepanik AB, Stefanska E, Buczma A, 2006. Preliminary results of HBV DNA testing of Polish haemophilia patients–lack of occult HBV infection. Haemophilia 12: 380383.

    • Search Google Scholar
    • Export Citation
  • 32.

    Muto J, Sugiyama M, Shirabe K, Mukaide M, Kirikae-Muto I, Ikegami T, Yoshizumi T, Yamashita YI, Maehara Y, Mizokami M, 2018. Frequency and characteristics of occult hepatitis B infection among hepatocellular carcinoma patients in Japan. Ann Hepatol 17: 596603.

    • Search Google Scholar
    • Export Citation
  • 33.

    Shim CW, Park JW, Kim SH, Kim JS, Kim BH, Kim SH, Hong EK, 2017. Noncirrhotic hepatocellular carcinoma: etiology and occult hepatitis B virus infection in a hepatitis B virus-endemic area. Therap Adv Gastroenterol 10: 529536.

    • Search Google Scholar
    • Export Citation
  • 34.

    El-Maksoud MA, Habeeb MR, Ghazy HF, Nomir MM, Elalfy H, Abed S, Zaki MES, 2019. Clinicopathological study of occult hepatitis B virus infection in hepatitis C virus-associated hepatocellular carcinoma. Eur J Gastroenterol Hepatol 31: 716722.

    • Search Google Scholar
    • Export Citation
  • 35.

    Fang Y, Shang QL, Liu JY, Li D, Xu WZ, Teng X, Zhao HW, Fu LJ, Zhang FM, Gu HX, 2009. Prevalence of occult hepatitis B virus infection among hepatopathy patients and healthy people in China. J Infect 58: 383388.

    • Search Google Scholar
    • Export Citation
  • 36.

    Mahmoud AI, Elsherbiny NM, Afifi NA, Ahmed BM, Yasin AS, 2018. Occult hepatitis B infection among blood donors in Al Azhar University Hospital, upper Egypt: the current status after 25 years of vaccine introduction. Egypt J Immunol 25: 4556.

    • Search Google Scholar
    • Export Citation
  • 37.

    Athira K, Vanathy K, Kulkarni R, Dhodapkar R, 2018. The prevalence of occult hepatitis B infection among the blood donors in a tertiary care hospital, Puducherry. Indian J Med Microbiol 36: 426428.

    • Search Google Scholar
    • Export Citation
  • 38.

    Rios-Ocampo WA, Cortes-Mancera F, Olarte JC, Soto A, Navas M-C, 2014. Occult hepatitis B virus infection among blood donors in Colombia. Virol J 11: 206.

    • Search Google Scholar
    • Export Citation
  • 39.

    El Banna N, El Jisr T, Samaha H, El Chaar M, 2017. Low prevalence of occult hepatitis B infection among blood donors in Beirut, Lebanon: reconsider the deferral strategy of anti-HBc positive blood donors. Hepat Mon 17: e14250.

    • Search Google Scholar
    • Export Citation
  • 40.

    Shambesh M, Franka E, Agila A, Ismail F, 2018. Frequency of hepatitis B core antibody and hepatitis B virus DNA among apparently healthy male blood donors in eastern Libya. Libyan J Med Sci 2: 1215.

    • Search Google Scholar
    • Export Citation
  • 41.

    Costa JEF, Morais VMS, Gonçales JP, Medeiros AADP, Barroso H, Compri AP, Fukasawa L, Moreira RC, Coêlho MRCD, 2019. Occult hepatitis B virus infection in patients with leprosy. J Med Virol 91: 775780.

    • Search Google Scholar
    • Export Citation
  • 42.

    Yang L, Li T, Li W, Tang X, Li J, Long R, Fu Y, Allain JP, Li C, 2017. Occult hepatitis B virus infection in hyperlipidemia patients. Tohoku J Exp Med 241: 255261.

    • Search Google Scholar
    • Export Citation
  • 43.

    Najafi F, Baghbanian M, Danaii Z, 2018. Prevalence of occult hepatitis B in patients with lupus nephritis and glomerulopathy referred to Shahid Sadoughi Hospital in Yazd, Iran. Internal Medicine and Medical Investigation Journal 3: 28.

    • Search Google Scholar
    • Export Citation
  • 44.

    Carimo AA, Gudo ES, Maueia C, Mabunda N, Chambal L, Vubil A, Flora A, Antunes F, Bhatt N, 2018. First report of occult hepatitis B infection among ART naive HIV seropositive individuals in Maputo, Mozambique. PLoS One 13: e0190775.

    • Search Google Scholar
    • Export Citation
  • 45.

    Samadi E, Mirshahabi H, Motamed N, Sadeghi H, 2020. Prevalence of occult hepatitis B virus infection in hemodialysis patients using nested PCR. Rep Biochem Mol Biol 9: 82.

    • Search Google Scholar
    • Export Citation
  • 46.

    Ameli M, Besharati S, Nemati K, Zamani F, 2008. Relationship between elevated liver enzyme with iron overload and viral hepatitis in thalassemia major patients in northern Iran. Saudi Med J 29: 16111615.

    • Search Google Scholar
    • Export Citation
  • 47.

    Abrishami F, Golshan A, 2018. The prevalence of HBsAg, anti-HCV, and anti-HBc in patients with β-thalassemia referred to blood banking department of Ghaem Hospital in Mashhad, Northeast of Iran. Int J Infect 5: e81518.

    • Search Google Scholar
    • Export Citation
  • 48.

    Mohammadi S, Khodabandehloo M, 2017. Prevalence of hepatitis C virus antibodies among beta-thalassemia major patients in Kurdistan Province, Iran. Arch Clin Infect Dis 12: e62419.

    • Search Google Scholar
    • Export Citation
  • 49.

    Ahmadi Vasmehjani A, Yaghubi S, Hashemi SM, Farahmand M, Adeli OA, Taravand AH, Beiranvand M, 2018. The prevalence of hepatitis B, hepatitis C, and human immunodeficiency virus infections among β-thalassemia major: a multicenter survey in Lorestan, West of Iran. Iran J Ped Hematol Oncol 8: 111117.

    • Search Google Scholar
    • Export Citation
  • 50.

    Mahmoud RA, El-Mazary A-AM, Khodeary A, 2016. Seroprevalence of hepatitis C, hepatitis B, cytomegalovirus, and human immunodeficiency viruses in multitransfused thalassemic children in upper Egypt. Adv Hematol 2016: 17.

    • Search Google Scholar
    • Export Citation
  • 51.

    Biswas S, Candotti D, Allain J-P, 2013. Specific amino acid substitutions in the S protein prevent its excretion in vitro and may contribute to occult hepatitis B virus infection. J Virol 87: 78827892.

    • Search Google Scholar
    • Export Citation
  • 52.

    Blumberg BS, 1979. Sex differences in response to hepatitis B virus. Arthritis & Rheum 22: 12611266.

 
 

 

 

 

 

 

 

Occult Hepatitis B Virus Infection among β-Thalassemia Major Patients in Ahvaz City, Iran

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  • 1 Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran;
  • | 2 Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran;
  • | 3 Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

ABSTRACT.

Occult Hepatitis B Infection (OBI) is a critical risk factor for triggering post-transfusion hepatitis (PTH), cirrhosis, hepatocellular carcinoma, and hepatitis B virus (HBV) reactivation, which β-thalassemia major (BTM) patients are at risk of it due to multiple blood transfusions. This study was aimed at determining the prevalence of OBI among BTM patients from Khuzestan Province, Iran. In this cross-sectional study, 90 thalassemia patients, who have received blood 36 to 552 times, participated referred to the Shafa hospital of Ahvaz city from January 2018 to April 2019. ELISA for determining serological markers (HBsAg, anti-HBc, anti-HBs, and anti-HCV) and real-time PCR for detecting HBV-DNA were performed; Nested PCR was conducted for DNA sequencing and determining the genotype of OBI case. Phylogenetic and statistical analyses were done by R package. Of 90 subjects enrolled in this study; 95.5% (86/90) were HBsAg negative, and the frequency of OBI among them was 1.16% (1/86). The anti-HBs, anti-HBc, and anti-HCV were detected in 80.00%, 7.78%, and 12.2% of patients, respectively. HBV-DNA was assessed at four HBsAg-positive subjects as well, and all of them were negative. The phylogenetic analysis showed that the detected HBV DNA in the OBI case belongs to the genotype D. This research, for the first time, demonstrated that OBI is present among β-thalassemia patients in Iran. Also, further studies are necessary to determine the actual prevalence of OBI among BTM patients in Iran to decisions concerning OBI screening, especially in transfusion centers.

Author Notes

Address correspondence to Shahram Jalilian, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. E-mail: norovirus2009@gmail.com

Authors’ addresses: Fatemeh Amirhashchi, Azarakhsh Azaran, and Shahram Jalilian, Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, E-mails: sara.amirhashchi@gmail.com, azarakhsh.azaran@yahoo.com or azaran.a@ajums.ac.ir, and norovirus2009@gmail.com. Seyed Saeid Seyedian, Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, E-mail: seyedian-ss@ajums.ac.ir. Bijan Keikhaei, Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, E-mail: keikhaei-b@ajums.ac.ir.

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