Muhammad Omar Qureshi, Farzana Shafqat, Nasir Khokhar.
Frequency of occult hepatitis b in patients awaiting liver transplant.
Pak J Med Res Jan ;53(1):7-10.

Background: Some patients do not have conventional markers of hepatitis B i.e. HBsAg, HBeAg. However, they may still carry viral DNA. This group of patients who got negative HBsAg but detectable HBV DNA by PCR is defined to have occult hepatitis B (OHB). Occult hepatitis B can reactivate and affect transplanted liver when given immunosuppressants. Objectives: To determine the frequency of occult hepatitis B in patients on waiting list for liver transplant in Shifa International Hostpital, Islamabad, Pakistan. Study type, settings and duration: Prospective non-interventional study was carried out at Gastroenterology unit of Shifa International Hospitals, Islamabad from April 2012 to May 2013. Materials and Methods: One hundred and twenty three patients on the waiting list for liver transplant were included in the study after fulfilling inclusion criteria. All the baseline laboratory tests including complete hepatitis profile HBsAg, HBc IgM and IgG, Anti HCV and HBV DNA by PCR were performed. Data were collected in specially designed proforma. All the data were analyzed using SPSS version 16.0. Results: Out of 123 patients, 67(54.4%) were male and 56(45.5 %) were female. Mean age was 52.7+11.06. Nine (7.31%) patients were found to have occult hepatitis B. Out of these 9 patients, 5(55%) had HCV as primary cause of their liver disease, 2(22%) had HCC and 2(22%) had cryptogenic liver disease, which is diagnostic of exclusion. Conclusion: Occult hepatitis B is the ignored entity in Pakistan. Our study showed that occult hepatitis B was detectable in our population with liver disease. It is important to check its presence in all patients of chronic liver disease regardless of the primary aetiology of liver disease.

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