New approach to managing occult hepatitis B infection

摘要

I read with great interest the paper by Taheri et al. publishedin (1) Hepatitis Monthly (Number 31, February2011). The results of this follow-up study are hopeful ofhepatitis-B vaccine efficacy in patients who lost HBsAgand did not seroconvert to anti-HBs with no detectableHBV DNA. However, the editorial in the same issue, aswell as Taheri et al. themselves, noted some importantlimitations to this study (2). According to the findingsof a meta-analysis by Poorolajal et al. (3), the protectionprovided by the HBV vaccine is dependent on immunememory rather than circulating anti-HBs titer. Therefore,it would be worthwhile to observe the anamnestic immuneresponse to HBsAg in such patients. Furthermore,such an investigation should include observations ofspontaneous developing anamnestic immune response.The authors prefer an artus HBV RG PCR kit for HBV DNAdetection but not for quantification. Because of thelower analytic sensitivity (10.22 IU/ml), the artus HBV QSRGQ kit (QIAGEN GmbH, Hilden Germany) would be anincorrect chocie for this study design. Therefore, absentof measuring the HBV viral load as stated in the editorial,the HBV RG PCR kit does not present any limitations forfollowing-up with occult hepatitis B patients.