What Is Occult Hepatitis?

Occult hepatitis refers to a condition where individuals exhibit clinical signs of chronic hepatitis, such as fatigue, loss of appetite, and abdominal discomfort, along with elevated liver enzymes during liver function tests. However, standard hepatitis B tests, including the hepatitis B surface antigen (HBsAg) test, come back negative. Despite this, the hepatitis B virus (HBV) DNA is found to be positive in both blood and liver tissue.

One of the key features of occult hepatitis is the presence of HBV DNA despite a negative HBsAg result. In some cases, patients may also test positive for hepatitis B surface antibody (anti-HBs), hepatitis B e antibody (anti-HBe), or hepatitis B core antibody (anti-HBc). Studies suggest that approximately 20% of individuals with occult chronic hepatitis B show completely negative results across all five standard hepatitis B markers.

Because of these atypical results, diagnosis typically relies on detecting HBV DNA through highly sensitive molecular tests. If a person has persistently or intermittently abnormal liver enzymes and no clear cause for liver damage, HBV DNA testing should be considered. In certain situations, especially when the diagnosis remains unclear, a liver biopsy may be necessary to detect HBV DNA in liver tissue.

This condition highlights the importance of advanced diagnostic techniques in identifying hidden viral infections that standard blood tests may miss. Early detection and proper management are crucial to preventing long-term liver damage.