Journal of Viral Hepatitis最新文献

{"title":"Patient Source of Referral Is a Key Determinant of Subsequent Retention in Care for Young Chronic Hepatitis B Patients","authors":"David Mutimer,&nbsp;Maxine Brown,&nbsp;Jacqueline Logan,&nbsp;Chayarani Kelgeri","doi":"10.1111/jvh.14059","DOIUrl":"10.1111/jvh.14059","url":null,"abstract":"<p>Hepatitis B elimination objectives can only be realised if new patient linkage to care is matched by long-term patient retention in care. We previously showed in adult chronic hepatitis B (CHB) patients that retention in care was inferior in younger patients and in patients from non-Asian ethnicities. The present study explores further the rates and determinants of loss to follow-up in a cohort of 271 young patients (aged 16–21 years at baseline). 16% of patients were lost to follow-up after a single consultation, and retention in care at 5 and 10 years was 53.7% and 45.9%, respectively. Retention in care was strongly associated with the source of patient referral and was superior for patients referred from the antenatal clinic and those transitioned from paediatric care (68% retention at 5 years for both sources) compared with those from “other” sources (36% at 5 years). In multivariate analyses, patient source of referral and distance of current residence from the Hepatitis Outpatient Clinic were the significant determinants of loss to follow-up. Retention in care may have been promoted by the transition process for those diagnosed in childhood and by the repeated referral from the antenatal clinic of women who had multiple pregnancies during the observation period. Only 20% of asylum seekers and referrals from genitourinary clinics were retained in follow-up at 10 years from baseline. This identifies a group of patients who do not access medical care, cannot benefit from treatment, and who may constitute a long-term public health risk.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization of the Use of APRI and FIB-4 for Ruling Out Liver Cirrhosis in Chronic Hepatitis B Patients With Normal Alanine Aminotransferase","authors":"Zhiyi Zhang,&nbsp;Jian Wang,&nbsp;Li Zhu,&nbsp;Yiguang Li,&nbsp;Shaoqiu Zhang,&nbsp;Yifan Pan,&nbsp;Yuxin Chen,&nbsp;Shengxia Yin,&nbsp;Xiaomin Yan,&nbsp;Xingxiang Liu,&nbsp;Yuanwang Qiu,&nbsp;Chao Wu,&nbsp;Jie Li,&nbsp;Chuanwu Zhu,&nbsp;Rui Huang","doi":"10.1111/jvh.14057","DOIUrl":"10.1111/jvh.14057","url":null,"abstract":"<div>\u0000 \u0000 <p>The exclusion of cirrhosis is important in chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT). We aimed to optimise the performance of the aspartate aminotransferase to platelet ratio index (APRI) and fibrosis score based on four factors (FIB-4) to exclude cirrhosis in these patients. Five hundred and eighty four patients with normal ALT who underwent liver biopsy were included in the study. The patients were divided into derivation and external validation sets. A grid search method was used to identify new cut-offs with a negative predictive value (NPV) of &gt; 95% and a sensitivity of &gt; 90% for detecting cirrhosis. The proportion of patients with cirrhosis in the derivation and validation sets was 19.4% and 7.5%, respectively. The conventional cut-offs of APRI (77.6%) and FIB-4 (41.8%) had high rates of cirrhosis misclassification. A new APRI cut-off of 0.21 had a sensitivity of 97.0% and an NPV of 95.6%, and only two (3.0%) patients with cirrhosis were misclassified in the derivation set. Using a new FIB-4 cut-off of 0.53, with a sensitivity of 98.5% and NPV of 96.2%, only one (1.5%) patient with cirrhosis was misclassified. External validation showed similar results. Using the new cut-offs of APRI and FIB-4, cirrhosis could be completely excluded for HBeAg-positive patients or those aged &gt; 40 years. The conventional cut-offs had high misclassification rates for cirrhosis. The new cut-offs of APRI (≤ 0.21) and FIB-4 (≤ 0.53) could be used to exclude cirrhosis in CHB patients with normal ALT levels with a low misclassification rate.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Systematic Review of Barriers and Facilitators to Hepatitis B and C Programmes in Prisons","authors":"Heidi Emery,&nbsp;Catrin Evans,&nbsp;Kathryn Jack,&nbsp;Elisa Martello,&nbsp;Princella Seripenah,&nbsp;Fatima Aiyelabegan,&nbsp;Surakshya Dhungana,&nbsp;Titus Joseph,&nbsp;Dirontsho Koboto,&nbsp;Joanne R. Morling,&nbsp;James Stewart-Evans,&nbsp;Emma Wilson,&nbsp;Jo Leonardi-Bee","doi":"10.1111/jvh.14049","DOIUrl":"10.1111/jvh.14049","url":null,"abstract":"<p>The prevalence of viral hepatitis among people in prisons is higher than in the general population. Screening, treatment and vaccination programmes exist within prisons to reduce the incidence of hepatitis, although lower uptake has often been reported compared to similar programmes outside of prisons. We conducted a systematic review of qualitative evidence to explore the barriers and facilitators to hepatitis B and C reduction programmes in prisons from the perspectives of people in prison, custodial staff and prison healthcare staff. Comprehensive searches of five databases (to November 2023) yielded 28 studies for review inclusion. Four synthesised findings were identified: (i) accurate, up-to-date knowledge of viral hepatitis disease and treatment among people in prison and staff is a facilitator to programme uptake, particularly when imparted by a trusted source; (ii) personal subjective and relative views have a bearing on participation with the programme; (iii) social interactions and relationships both within the community of people in prison and between them and staff groups influence participation in the programmes; and (iv) the organisational structure of the prison and healthcare services within it affect programme participation. Based on these findings, we make recommendations for the adaptation of viral hepatitis programmes to individual custodial settings thereby improving equitable programme access and hepatitis B and C reduction in this complex environment.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Features and Transition of Acute Hepatitis B Virus Infection","authors":"Huali Wang,&nbsp;Jian Wang,&nbsp;Shaoqiu Zhang,&nbsp;Shuai Zhang,&nbsp;Zhiyi Zhang,&nbsp;Jiacheng Liu,&nbsp;Yifan Pan,&nbsp;Chao Jiang,&nbsp;Ye Xiong,&nbsp;Tao Fan,&nbsp;Rui Huang,&nbsp;Li Li","doi":"10.1111/jvh.14048","DOIUrl":"10.1111/jvh.14048","url":null,"abstract":"<div>\u0000 \u0000 <p>Acute hepatitis B (AHB) is generally a self-limiting illness in adults and most patients achieve hepatitis B surface antigen (HBsAg) clearance within 6 months. We aimed to investigate the proportion and influencing factors of chronic outcome in adult AHB patients. A total of 126 consecutive AHB patients were included between January 2013 and October 2018. Multivariate regression analysis was conducted to evaluate the influencing factor of HBsAg clearance. Fourteen (11.1%) patients failed to achieve HBsAg clearance within 6 months. Among them, nine patients achieved HBsAg clearance within 6–12 months, while five patients had persistent HBsAg positive over 1 year. Patients with HBsAg clearance had lower baseline antibody to hepatitis B core antigen (anti-HBc) (7.0 S/CO vs. 8.0 S/CO, <i>p</i> = 0.090) and HBsAg levels than those with chronicity of AHB. Multivariate analysis revealed that HBsAg ≤ 250 IU/mL (HR 3.008, IQR 1.877, 4.820, <i>p</i> &lt; 0.001) and anti-HBc levels (HR 0.830, IQR 0.755, 0.912, <i>p</i> &lt; 0.001) was significantly associated with HBsAg clearance. Anti-HBc remained an independent predictor of HBsAg clearance in different HBsAg subgroups. Patients with HBsAg &gt; 250 IU/mL (<i>p</i> &lt; 0.001) and high anti-HBc (<i>p</i> = 0.001) had lower cumulative HBsAg clearance rates than those with low HBsAg and anti-HBc. 11.1% of AHB patients did not achieve HBsAg clearance within 6 months, while the proportion of patients with persistent HBsAg positive decreased to 4.0% after 1 year. Combination of baseline HBsAg and anti-HBc levels could identify patients who might have a possible risk of chronicity following AHB.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 2","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B Patients' Adherence to Treatment in Relation to Knowledge, Attitudes, and Practices (KAP) in the West Bank, Palestine, 2022–2023","authors":"Ayham Sawalmeh,&nbsp;Emily White Johansson,&nbsp;Danis Kostas,&nbsp;Dia'a Hjaijeh","doi":"10.1111/jvh.14055","DOIUrl":"10.1111/jvh.14055","url":null,"abstract":"<p>Hepatitis B is an infectious disease that inflicts high health and economic costs on the healthcare system. Poor adherence to treatment increases that cost. We aimed to assess the levels of knowledge, attitudes and practices (KAP) among patients in the West Bank, Palestine, and identify factors associated with good adherence. We conducted a cross-sectional study surveying hepatitis B patients visiting primary healthcare during October 2022 until June 2023 using an interviewer-administered questionnaire covering qualitative and quantitative aspects regarding hepatitis B. We considered adherence as good if participants received &gt; 90% of their monthly prescription antiviral doses. Among 386 participants, the median age was 45 years (range 20–81); 80% had good adherence to treatment. Mean knowledge score was 11.4 (on a 13-point scale), mean attitude score was 3.4 (on a 4-point scale), mean practices score was 6 (on a 7-point scale) and the mean overall KAP score was 21.8 (on a 24-point scale). KAP components (Cronbach alpha = 0.820) were correlated with good adherence (<i>p</i> &lt; 0.001). After adjustment for other factors, participants with good KAP scores had better adherence to treatment than those without (prevalence ratio: 1.41, 95% CI: 1.10–1.84, <i>p</i>-value = 0.011). We recommend investment in education and awareness campaigns to improve adherence.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interaction Between Hepatitis B, Hepatitis C and Alcohol in the Development of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis","authors":"Jalal Poorolajal,&nbsp;Yahya Shadi,&nbsp;Bahram Heshmati","doi":"10.1111/jvh.14042","DOIUrl":"10.1111/jvh.14042","url":null,"abstract":"<div>\u0000 \u0000 <p>The objective of this report is to provide clarification on the interaction among hepatitis B virus (HBV), hepatitis C virus (HCV) and alcohol in the development of hepatocellular carcinoma (HCC). A systematic search was performed in PubMed, Web of Science and Scopus databases up to July 18, 2023. The inclusion criteria involved observational studies that examined the relationship between HBV, HCV, alcohol use and the development of HCC. To assess between-study heterogeneity, the <i>I</i>² statistics were employed. Publication bias was evaluated using the Begg and Egger tests. The effect sizes were estimated as odds ratios (ORs) with 95% confidence intervals (CIs) utilising a random-effects model. Among the initial pool of 31,021 studies identified, 28 studies involving 42,406 participants met the inclusion criteria. Through our meta-analysis, we found that the combined effect of HBV and alcohol was associated with an OR of 14.56 (95% CI: 9.80, 21.65). The combined impact of HCV and alcohol showed an OR of 42.44 (95% CI: 20.11, 89.56). Coinfection with both HBV and HCV was associated with an OR of 32.58 (95% CI: 20.57, 51.60). These results emphasising the importance of reducing alcohol consumption and implementing effective viral hepatitis prevention and treatment.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Course of COVID-19 Infection in Patients With Chronic Hepatitis Delta","authors":"Yavuz Emre Parlar,&nbsp;Müge Özarı Gülnar,&nbsp;Beril Kırmızıgül,&nbsp;Genco Gençdal,&nbsp;Müjdat Zeybel,&nbsp;Onur Keskin,&nbsp;Cihan Yurdaydın","doi":"10.1111/jvh.14054","DOIUrl":"10.1111/jvh.14054","url":null,"abstract":"<div>\u0000 \u0000 <p>In coronavirus disease 2019 (COVID-19), older age and co-morbidities are associated with mortality. Among liver disease aetiologies alcoholic liver disease was associated with mortality. Chronic hepatitis delta (CHD) had not been studied. The current study explores course of COVID-19 disease in chronic hepatitis B (CHB) and CHD. This retrospective study included CHB and CHD patients from the gastroenterology departments of Hacettepe and Koç University Hospitals. COVID-19 was confirmed via PCR testing for SARS-CoV-2 RNA. Data on liver disease severity, including MELD-Na and Child-Pugh scores, as well as vaccination status, were collected. A total of 618 patients (343 M/275 F) were evaluated, comprising 540 CHB patients (27 [5%] cirrhotic) and 78 CHD patients (43 [55%] cirrhotic). COVID-19 was diagnosed in 47 CHB patients (8.7%) and 12 CHD patients (15.4%), <i>p</i> = NS. Hepatic reactivation occurred in 3 CHB patients (6.3%) and 4 CHD patients (33%), (<i>p</i> = 0.018). Reactivation was more frequent in cirrhotic patients than non-cirrhotic patients (50% vs. 4%, <i>p</i> = 0.0009). One cirrhotic CHB patient decompensated, while one cirrhotic CHD patient died and another developed hepatic decompensation. The majority of cirrhotic CHB patients (96.3%) were receiving nucleos(t)ide analogues (NAs), whereas only one cirrhotic CHD patient was on treatment for Hepatitis D virus (HDV). Although the small number of CHD patients and COVID-19-positive cases limits definitive conclusions, CHD patients may experience a more severe course of COVID-19 compared to CHB patients. This may be due to the higher proportion of cirrhotics among CHD patients and the lack of effective antiviral treatment for HDV.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B Care and Treatment in Zanzibar, Tanzania: A Demonstration Project Following 2015 WHO Treatment Guidelines, 2017–2021","authors":"Sanaa S. Said,&nbsp;Shaun Shadaker,&nbsp;Brian J. McMahon,&nbsp;Paige A. Armstrong,&nbsp;Geoff A. Beckett,&nbsp;Saleem Kamili,&nbsp;Aaron M. Harris","doi":"10.1111/jvh.14051","DOIUrl":"https://doi.org/10.1111/jvh.14051","url":null,"abstract":"<div>\u0000 \u0000 <p>Zanzibar, a low-resource semiautonomous region of Tanzania, has an estimated prevalence of hepatitis B virus (HBV) infections of 3.6%. To assess the feasibility of care and treatment, a 5-year hepatitis B demonstration project was implemented in Zanzibar during January 2017–December 2021, following the 2015 WHO HBV care and treatment guidelines. Participants included adults (aged ≥ 18 years) who tested positive for HBV surface antigen and tested negative for HIV and hepatitis C antibody. Participants were examined for clinical signs of liver disease and testing was conducted at baseline to assess treatment eligibility and every 6–12 months thereafter. Tenofovir disoproxil fumarate (TDF) was provided at no cost to treatment-eligible participants. Clinical and laboratory data were analysed to assess improvement in proximal disease outcomes. Among 596 participants enrolled, the median age was 32 years (IQR 26–39) and 365 (61%) were male. Of those enrolled, 268 (45%) returned for ≥ 1 follow-up visit, with a median of 511 days of follow-up. Overall, 58 patients initiated treatment: 15 met treatment criteria based on liver cirrhosis alone; 13 by APRI &gt; 1.5; among those with HBV DNA results, six met criteria based on HBV DNA levels and ALT activity; 24 met ≥ 2 criteria. Significant decreases in ALT activities, APRI scores and HBV DNA levels were observed among those treated. This hepatitis B care and treatment programme was demonstrated to be feasible in a low-resource setting. Despite challenges, testing and linkage to care is critical to decrease the global burden of hepatitis B.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Health Systems Strengthening Approach to Address the High Burden of Hepatitis C in Pakistan","authors":"Mahnoor Qureshi","doi":"10.1111/jvh.14050","DOIUrl":"https://doi.org/10.1111/jvh.14050","url":null,"abstract":"<p>Hepatitis C virus infection is a serious liver disease that can progress to cirrhosis and, in chronic cases, lead to liver cancer or liver failure. Pakistan has the second highest burden of HCV in the world, a rising number of liver cancer cases and a unique pattern of healthcare-associated HCV transmission. Unfortunately, the country is not on track to meet the WHO's target of complete elimination of HCV by 2030. The current reliance on vertical programmes for hepatitis elimination may seem effective in the short term, but is often unsustainable, ineffective and contributes to the fragmentation of the health system. This review proposes a health system strengthening approach to HCV detection and prevention in the country. It critically evaluates the country's health system and the existing evidence on HCV prevention and treatment, proposing evidence-based strategies for decentralising HCV services and integrating them into the primary healthcare infrastructure. It examines the effectiveness of methods such as task shifting and targeted interventions while suggesting changes to healthcare practices to reduce healthcare-associated transmission of HCV and other blood-borne pathogens.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.14050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142861883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Misuse of the Lower Limit of Detection in HBV DNA Testing and Anti-HBe Positive Status Will Significantly Impact the Diagnosis of Occult HBV Infection","authors":"Bo Wang,&nbsp;Xinru Wang,&nbsp;Li Xiao,&nbsp;Jianchun Xian","doi":"10.1111/jvh.14046","DOIUrl":"10.1111/jvh.14046","url":null,"abstract":"<div>\u0000 \u0000 <p>The diagnosis of occult hepatitis B virus (HBV) infection (OBI) is influenced by factors such as the lower limit of detection (LOD) of the HBV DNA test. However, in clinical practice and scientific research, the lower limit of quantification (LOQ) is often misused as the LOD. This study aims to investigate the impact of misuse of the LOD of the HBV DNA test on the detection rate of OBI, as well as the risk factors for OBI. Four hundred twelve patients who were HBsAg-negative and had undergone high-sensitivity HBV DNA testing were included in this study. HBV DNA was detected using the Cobas 6800 System with an LOD of 2.4 IU/mL and an LOQ of 10 IU/mL. The effect of using the LOQ as the LOD on the detection rate of OBI was compared, and univariate and multivariate logistic regression analyses were used to explore the risk factors for OBI. (1) Of the 412 patients, 63.3% (<i>n</i> = 261) were male, with a median age of 47 (range 34–55) years. A total of 473 HBV DNA test results were obtained, with 366 individuals undergoing only one HBV DNA test and the remaining 46 patients undergoing 2 to 5 HBV DNA tests (resulting in a total of 107 test results). (2) Considering only the first HBV DNA test result, the detection rate of OBI was 4.1% (17/412). However, when the LOQ (10 IU/mL) was used as the LOD, the detection rate of OBI was only 1.5% (6/412) (<i>p</i> &lt; 0.001). (3) Univariate analysis showed that there were statistically significant differences in age, anti-HBe positivity rate and anti-HBc positivity rate between OBI and non-OBI individuals (<i>p</i> &lt; 0.05). Multivariate regression analysis showed that anti-HBe positivity was an independent risk factor for OBI in this study (odds ratio [OR] = 3.807, 95% confidence interval [CI]: 1.065–13.617, <i>p</i> = 0.040), while anti-HBs positivity was a protective factor against OBI (OR = 0.271, 95% CI: 0.093–0.787, <i>p</i> = 0.016). (4) Among the 46 patients who underwent repeated testing, a total of seven individuals were found to be HBV DNA-positive in the first test, and six individuals tested positive for HBV DNA one or more times in subsequent tests. When OBI was confirmed by ≥ 1 out of 1–5 tests with detectable HBV DNA, the detection rate of OBI in this study could increase from 4.1% to 5.6%. The detection rate of OBI among HBsAg-negative adult patients attending hepatology departments in this region is 4.1%. Misusing the LOQ as LOD can significantly decrease the detection rate of OBI. The presence of anti-HBe positivity and undergoing multiple HBV DNA tests can lead to a significant increase in the detection rate of OBI.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}