Mohammad, Athirah (2022) Serological and molecular detection of seropositive occult hepatitis B virus infection in hepatitis B surface antigen-negative sera at Hospital USM, Kelantan. Masters thesis, Universiti Sains Malaysia.
![[img]](http://eprints.usm.my/style/images/fileicons/application_pdf.png) |
PDF
Download (944kB) |
Abstract
Introduction: Over the years, data has been gathered worldwide on occult hepatitis B virus infection (OBI), proving its transmissibility and clinical implication. Despite the potential threat of OBI, there are no standardised methods to screen and confirm OBI. We aimed to determine the prevalence of OBI in Malaysia by using hepatitis B core antibodies (Anti-HBc) as a marker of hepatitis B virus (HBV) infection. Materials and methods: A total of 955 Hepatitis B surface antigen (HBsAg)-negative sera were selected from blood donors and patients screened for HBsAg using highly sensitive electrochemiluminescence immunoassay (ECLIA) at the Microbiology Laboratory and Blood Donation Unit, Hospital Universiti Sains Malaysia (HUSM) between August 2021 until August 2022 were tested with Anti-HBc antibodies. Highly specific HBV nested polymerase chain reaction (PCR) was performed on samples reactive to anti-HBc to identify seropositive OBI. In addition, the proportion of reactive anti-HBc and OBI was determined, and data on the sociodemographic, clinical history and associated factors were gathered retrospectively. Results: 56 of the 955 (5.9%) were found to be reactive anti-HBc, of which 95%(53/56) were also reactive for hepatitis B surface antibodies (anti-HBs), implying immunity from previous HBV infection and 5% (3/56) were isolated anti-HBc.14.5% (8/55) seropositive OBI (Anti-HBc+/Anti-HBs+) were detected by nested PCR amplification of the HBV S gene and 62.5% (5/8) seropositive OBI were healthy blood donors. No risk factors were found to be associated with the presence of HBV DNA among those who tested positive. Analysis of blood parameters showed lower total white cell count and C-reactive protein level among the reactive anti-HBc subjects. Conclusion: This study revealed a lower proportion of seropositive OBI (14.5%) detected by using anti-HBc as a marker of infection than prior studies, probably limited by the advancement in sensitivity of current HBsAg assays used and lower nested PCR detection due to single occasion HBV DNA test applied. Based on this data, the exact prevalence of OBI in Malaysia is still undetermined. It is alarming that OBI was predominantly found among blood donors. Adopting anti-HBc as a complementary marker of HBV infection requires further evaluation to achieve 'zero' healthcare-related transmission of HBV. Associated factors of OBI cannot be significantly determined due to the limited number of OBI cases identified in this study
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | occult hepatitis B infection, anti-HBc |
| Subjects: | R Medicine R Medicine > RA Public aspects of medicine > RA440-440.87 Study and teaching. Research |
| Divisions: | Kampus Kesihatan (Health Campus) > Pusat Pengajian Sains Perubatan (School of Medical Sciences) > Thesis |
| Depositing User: | MUHAMMAD AKIF AIMAN AB SHUKOR |
| Date Deposited: | 17 Mar 2026 01:40 |
| Last Modified: | 10 May 2026 01:43 |
| URI: | http://eprints.usm.my/id/eprint/63786 |
Actions (login required)
 |
View Item |
