High prevalence of occult hepatitis B infection in an African urban population

Betty S. Apica, Emmanuel Seremba, Jody Rule, He Jun Yuan, William M. Lee

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Occult hepatitis B infection (OBI), the presence of low hepatitis B virus (HBV) deoxyribonucleic acid (DNA) levels in patients without detectable hepatitis B surface antigen (HBsAg), has significant implications for understanding the natural history of hepatitis B infection. We determined the prevalence of OBI in African patients using a sensitive polymerase chain reaction (PCR) assay and describe here the characteristics of OBI in an urban African hospital population. Routine serological testing as well as molecular studies were performed on sera from 314 patients who were part of a previous study from an urban hospital emergency room in Kampala, Uganda, detecting HBV DNA using a nested PCR with amplification of two regions of the HBV genome. HBV viral loads (VL) were determined by real-time PCR (rtPCR) and sequencing performed to determine HBV genotype and S gene mutations. Among 314 subjects tested, 50 (16%) had chronic HBV infection, 94 (30%) had detectable HBV DNA despite testing HBsAg negative (OBI), and 170 (54%) were not infected. VLs of OBI subjects were relatively low although 19 (20%) had VL exceeding 104IUml-. Subjects with chronic HBV infection had a higher median VL compared to OBI patients (P<0.001). All chronic HBV sequenced (10) and 83/89 OBI sequences were genotype A, the remaining six being genotype D. S-gene mutations were present in some but not all OBI patients (48%). OBI is more prevalent among African patients than previously thought. This may have implications for clinical management and transfusion-related HBV transmission.

Original languageEnglish (US)
Pages (from-to)674-680
Number of pages7
JournalJournal of Medical Virology
Issue number4
StatePublished - Apr 1 2016


  • Hepatitis B
  • Occult HBV infection
  • Prevalence

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases


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