False Occult Hepatitis B Virus Infection with Negative HBsAg While Positive HBeAg & Overt DNA Levels: Case Report and Literature Review

Background: Occult Hepatitis B Infection (OBI) is characterized by the detection of Hepatitis B Virus (HBV) DNA in serum (usually HBV DNA < 200 IU/ml) or liver but negativity for hepatitis B surface antigen. The diagnosis of OBI is based on the sensitivity of assays used in the detection of HBV DNA and HBsAg. HBsAg assays with inadequate sensitivity or inability to detect HBV S variants may lead to a false negative HBsAg result and misdiagnosis of OBI in people with overt HBV infection. An OBI patient was followed 4 years with the analysis of HBV detection.