Clinical analysis of occult infection of hepatitis B virus

Objective To investigate the possible cause of hepatitis B vireus(HBV) replicative infection in the patients with negative hepatitis B serological markers(HBVM).Methods Liver biopsy was done in 65 cases.Of whom,16 cases had negative hepatitis B serological markers including HBsAg, anti-HBs,HBeAg,anti-HBe,anti-HBc and anti-HCV.ALT level of 6 cases (out of 16) was normal by repeated examination and they were suspected to be HBV carriers either by the evidence of clinical status or by having family history of hepatitis B.Eight patients were initialy diagnosed as chronic hepatitis,and 2 cases as liver cirrhosis.Results Of 6 HBV carriers,4 cases initiallly diagnosed as HBV carriers and all showed high viral replication with the load of 10~4～10~5 copies/ml and the periportal and/or intralobular inflammation degree of G1 and S1.Of 8 cases with chronic hepatitis,4 patients had a high load of 10~5～10~6 copies/ml,and 2 cases had a load of10~4 copies/ml.Conclusion Multiple mechanisms are involved in the occult asymptomatic infection of HBV.