The prevalence of occult hepatitis B virus infection in type 2 diabetes mellitus patients

Aim The prevalence of occult hepatitis B virus (HBV) infection is relatively frequent among patients with immune suppression. The impairment of the immune system is well demonstrated in diabetics. We aimed to investigate the prevalence of occult HBV infection among hepatitis B core antibody (HbcAb) +/- hepatitis B surface antibody (anti-HBs) positive type 2 diabetes mellitus patients. Materials and Methods The study involved 100 HBcAb +/- anti-HBs type 2 diabetes mellitus patients and 100 age and sex matched, HBcAb +/- anti-HBs healthy blood donors. Exclusion criteria were positive serology for HBsAg, hepatitis C virus or HIV, diagnosis of malignancy or earlier organ transplantation history, use of immunosuppressive therapy. All patients were questioned about their past medical history and were tested for serum alanine aminotransferase and HBV DNA level. Results The diabetic patients did not differ significantly from healthy controls in terms of sex and age. HBV DNA was detected in 11% of the diabetic patients (1 x 10(2)-5 x 10(3) copies/ml) and in 3% of the controls (4 x 10(3)-1 x 10(5) copies/ml). The difference between groups was statistically significant (P 0.05). The history of blood transfusion, surgery, and vaccination for HBV and alcohol use were similar in both groups (P>0.05). The serum alanine aminotransferase levels in diabetic patients were close to those of controls (26.2 +/- 16.4 IU/I vs. 23.9 +/- 9.7 IU/I; P>0.05). Conclusion These data suggest that the prevalence of occult HBV infection is higher in diabetics compared with healthy controls and this may contribute to the increased prevalence of primary hepatocellular carcinoma in diabetics.