High occult hbv despite hbsag negative by vaccine

[stef2011]

http://archive.mail-list.com/hbv_research/message/20120529.231442.b777eaab.en.html

Hepatitis B Molecular Laboratory, Department of Virology, School of
Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Abstract
BACKGROUND:
Occult hepatitis B virus (HBV) infection is a well-recognized clinical
entity characterized by the detection of HBV DNA in serum and/or in
liver in the absence of detectable hepatitis B surface antigen (HBsAg).
The frequency of the diagnosis depends on the relative sensitivity of
both HBsAg and HBV DNA assays.
OBJECTIVE:
To determine the prevalence of occult HBV infection in a high risk group
of children who developed HBV infection despite immunoprophylaxis.
METHODS:
the sera of 75 children born to HBsAg-positive mothers previously
immunized by HBIG and prophylaxic vaccine regimen were assayed for HBV
DNA by real-time PCR. Subsequently, the samples were tested by a
sensitive standard PCR employing independent set of primers for all HBV
genes and analyzed by direct sequencing.
RESULTS:
HBV DNA was detected in 21/75 (28%) of children, ranged between 77 and
9240 copies/mL. All were positive for anti-HBs. 5 (24%) were found to be
positive for anti-HBc, and anti-HBc-only positive individual were not
observed. 8 isolates (38%) did not contain any mutation. Other 13
infected children (62%) contained at least one mutation in regions known
to be involved in functional and/or immune epitope activity. 10 were
contained G145R mutations.
CONCLUSION:
HBV occult infection seems to be relatively frequent in immunized
children born to HBsAg-positive mothers. HBsAg negativity is not
sufficient to completely exclude HBV DNA presence. These findings
emphasize the consideration of occult HBV infection in hypo endemic areas.

[stef2011]

just keep checking every 6 months for both hbsag and hbvdna both tests need very very high sensibility
hbsag 0.05iu/ml or less
hbvdna 10iu/ml or less

in any case occult hbv has very very low probability of any damage or health issues, talk with your doctor about this keeping in mind that doctors not updated know nothing on occult hbv.
i am not expert at all on occult hbv but i guess if all negative for about 5 years it canbe considered cleared

[anmocchau]

It is really said to read this news. Every time one finds something to hope for, there is then a disappointment. What is the way out for our babies?

[stef2011]

this is due to the fact that vaccine is made with hbsag alone, future vaccines with hbsag, hbcag and possibly other parts of the virus may lower hbsag mutations.
at this point it is best to check both hbvdna every 6 months to exclude occult and not only hbsag negative