New approach to managing occult hepatitis B infection

I read with great interest the paper by Taheri et al. published in (1) Hepatitis Monthly (Number 31, February 2011). The results of this follow-up study are hopeful of hepatitis-B vaccine efficacy in patients who lost HBsAg and did not seroconvert to anti-HBs with no detectable HBV DNA. However, the editorial in the same issue, as well as Taheri et al. themselves, noted some important limitations to this study (2). According to the findings of a meta-analysis by Poorolajal et al. (3), the protection provided by the HBV vaccine is dependent on immune memory rather than circulating anti-HBs titer. Therefore, it would be worthwhile to observe the anamnestic immune response to HBsAg in such patients. Furthermore, such an investigation should include observations of spontaneous developing anamnestic immune response. The authors prefer an artus HBV RG PCR kit for HBV DNA detection but not for quantification. Because of the lower analytic sensitivity (10.22 IU/ml), the artus HBV QSc 2011 Kowsar M.P.Co. All rights reserved. Please cite this paper as: Sayan M. New approach to managing occult hepatitis B infection. Hepat Mon. 2011;11(4):299-300. Implication for health policy/practice/research/medical education: This letter to editor has been written to discussed of article published in Hepat Mon. 2011;11(2). The researcher and clinicians should be remembered of false HBsAg negativitiy in the management of occult hepatitis B patients.