Study of Occult Hepatitis (B) Infection in Hepatocellular Carcinoma Patients treated with Direct-acting antivirals

Objectives: to evaluate the prevalence of occult hepatitis B infection in Hepatocellular carcinoma (HCC) patients treated with Direct-acting antivirals (DAAs). Background: DAAs have changed the treatment approach to chronic hepatitis C (HCV) as they achieve high sustained virological response rates (SVRs) in cirrhotic patients and prolong overall survival with few side effects. Despite several studies addressing the prevalence of Occult hepatitis B virus infection (OBI), the pooled prevalence of OBI in Egypt remains unknown, especially in specific subpopulations such as HCC patients treated with direct antiviral drugs. OBI is defined as the presence of hepatitis B virus (HBV) DNA in the hepatocytes or serum of individuals who had tested negative for serum HBV surface antigen (HBsAg). Methods: A cohort of 300 Egyptian HCC patients who completed DAA treatment and tested negative for HBsAg. The study was conducted at the Outpatient Clinic of the Internal Medicine Department, Faculty of Medicine, Menoufia University, Egypt, and the Kafr El Sheikh Liver Center of Research, Egyptian Ministry of Health, Egypt. They underwent clinical examination, laboratory tests, and abdominal ultrasonography. Results: In the current study all patients were HBsAg negative. HBc IGgAb were positive in 18 patients and PCR HBV positive in 18 patients. So, out of 300 patients included in this study; 18/300 (6%) patients had OBI and all patients with OBI were positive for PCR HBV and HBc IGgAb. Conclusion: The prevalence of OBI was 6% in HCC Egyptian patients treated with DAAs.