Serologically Negative Occult Hepatitis B Infection among Egyptian Children, Prospective Study

Hepatitis B viral infections represent a major health problem especially in less developed countries. It was thought that vaccination can limit the problem but today there is no change in its occurrence.

The aims of the present study were to detect the occurrence of hepatitis B as an etiological virus in acute hepatitis in children, 2) to study the serological markers of this infections and to 3) evaluate the molecular mutations in these infections

One hundred pediatric patients with acute hepatitis were included in this study. Blood Samples were subjected to virological studies for each sample including both serological studies and molecular studies for hepatitis A, B, C and D viruses.

The virological studies revealed that 33% of them had positive IgM for HAV, 27% had positive HBsAg and 21% had positive IgG for HCV. Molecular diagnosis confirmed the presence of hepatitis B DNA in 45% of patients and 12% were positive for HCV –RNA. Sixty percent of patients had positive HBsAg and 40% were seronegative.

In this study, no specific mutation such as T131I, K141E and G145R was found in “α” determinant region, although there were other amino acid mutations in Pre-S and S regions in HBsAg positive cases.

From this study we can conclude that hepatitis B virus infection is still common among children in our country despite vaccination programmes. Seronegative occult hepatitis B infection is also common and represents a diagnostic challenge in those patients in the absence of serological markers.