Serum hepatitis B virus DNA detects cryptic hepatitis B virus infections in
multitransfused hemophilic patients
MG Rumi, M Colombo, R Romeo, G Colucci, A Gringeri and PM Mannucci
A. Bianchi Bonomi Hemophilia and Thrombosis Center, Institute of Internal
Medicine, University of Milan, Italy.
The recognition of replicating hepatitis B virus (HBV) may be important to
both define the cause of and know how to manage chronic liver disease in
multitransfused hemophilic patients. Replicating HBV can be detected at the
molecular level by methods for HBV-specific DNA (HBV- DNA), which are much
more sensitive than the immunologic methods for detecting hepatitis B
surface antigen (HBsAg) and hepatitis B e antigen (HBeAg). Unselected
hemophilic patients (260; 6% with HBsAg, 4% with isolated anti-hepatitis B
core (anti-HBc), 52% with anti-HBs and anti- HBc, 26% with isolated
anti-HBs, and 12% with no HBV marker) were investigated retrospectively
with a dot spot hybridization technique that detects serum HBV-DNA down to
0.5 pg and by Southern blot analysis, which tests the specificity of the
HBV-DNA reactions. Eighteen patients (7%; five with serum HBsAg and 13
HBsAg seronegative with antibodies to HBV) had serum HBV-DNA. Serum HBV-DNA
was detected more frequently in HBsAg carriers than in seronegative
patients (33% versus 6%, P less than .01), and had no relationship to serum
alanine aminotransferase. Serum HBV-DNA was more sensitive than the
radioimmunoassay for HBeAg was for detecting replicating HBV (7% versus
1.1%, P less than .01). These findings demonstrate that there is cryptic
HBV infection in a number of hemophiliacs and that serum HBV- DNA may
coexist with markers thought to reflect immunity against HBV.
Volume 75,
Issue 8,
pp. 1654-1658,
04/15/1990
Copyright © 1990 by The American Society of Hematology
