Evaluation of Chronic Hepatitis B Infection in Patients with Seronegative HbsAg

Abstract

Background: It is estimated that about 370 million people are chronic carriers of HBV worldwide. Apparently 3% of Iranian populations are chronic carriers of this virus. We aimed to evaluate the viral DNA in biological fluids of chronic hepatitis patients compared to a control group.
Methods: The current case-control study was designed to evaluate the viral DNA in biological fluids of 70 chronic hepatitis patients compared to a control group using ELISA, PCR and Real Time.
Results: All individuals (100%) in case group were HBsAg positive while in control group only 2 individuals (2.8%) were HBsAg positive. Three individuals , in control group were positive using PCR and Real Time PCR indicating that about 7% of those in control  group were chronic carriers of HBV. The interesting point was the copy of viral DNA; (5.49 ×10⁴, 2.162×10³and 7.26×10⁶) for 3 chronic carriers using sera while it was about (5.71×10³, 1.45×10² and 2.56×10⁵) using ear cerumen confirming the necessity of investigating for the carriers of HBV in different biological fluid and by different methods.
Conclusion: It can be concluded chronic carriers of hepatitis B are much more than what is diagnosed by routine diagnostic tests. On the other hand ELISA alone can not be relied on as a complete test for screening of chronic carriers in hepatitis B. PCR and Real Time PCR are more reliable tests for this purpose.