An estimation of the prevalence of occult HBV infection in Western Europe and in Northern America: A meta‐analysis. Issue 4 (26th December 2019)

• Record Type: Journal Article
• Authors: Pisaturo, Mariantonietta; Onorato, Lorenzo; Russo, Antonio; Chiodini, Paolo; Coppola, Nicola
• Is Part Of: Journal of viral hepatitis. Volume 27:Issue 4(2020)
• Page Start: 415
• Page End: 427
• Publication Date: 2019-12-26
• Subjects: anti‐HBc positivity -- HBV infection in western countries -- latent HBV infection -- occult HBV infection -- silent HBV infection; Hepatitis, Viral -- Periodicals; Hepatitis, Viral, Animal; Hepatitis, Viral, Human; 616.3623
• DOI: 10.1111/jvh.13248
• Languages: English
• ISSNs: 1352-0504

Abstract

Abstract: Data on the prevalence of occult HBV infection (OBI) in Western Europe and in Northern America are few; hence, we conducted a systematic review and meta‐analysis. All studies included had to fulfil the following inclusion criteria: (a) they investigated the prevalence of OBI (HBV DNA in liver tissue in HBsAg‐negative subjects), (b) were carried out in Western Europe and in Northern America; (c) were available as a full‐text manuscript, (d) written in English and (e) published up to December 2018. The exclusion criteria were as follows: (a) meta‐analyses, letters, reviews, meeting abstracts or editorial comments; (b) studies investigating HBsAg‐positive patients; (c) those investigating OBI outside Western Europe and in Northern America; and (d) to avoid small sample bias in the random‐effects model, those enrolling less than five subjects. Thirty‐four studies met the inclusion criteria, allowing a meta‐analysis on 2729 patients. The overall prevalence of OBI was 34% (95% CI = 26%‐42%), 28% (CI 95%: 12%‐48%) in 329 subjects without chronic liver disease and 35% (95% CI 26%‐44%) in 2400 patients with chronic liver disease. The prevalence of OBI was 51% (95% CI 40%‐62%) in the 823 anti‐HBc‐positive subjects and 19% (95% CI 10%‐30%) in the 1, 041 anti‐HBc‐negative subjects. Evaluating the data from 17 studies comparing anti‐HBc‐positive and negative subjects, the prevalence of OBI was higher in the 641 anti‐HBc‐positive subjects than in the 1041 anti‐HBc‐negative (prevalence ratio = 2.29; 95% CI = 1.61‐3.26, P < .001). This meta‐analysis showed that in HBsAg‐negative subjects the prevalence of OBI was high and was associated with anti‐HBc positivity.