SynthesisThe lancet. Gastroenterology & hepatology2022
Prevalence of occult hepatitis B virus infection in adults: a systematic review and meta-analysis.
Synthesis in The lancet. Gastroenterology & hepatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 4 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Long-Term Clinical Outcomes of Kidney Transplantation from Hepatitis B Surface Antigen (HBsAg)-Positive Donors to HBsAg-Negative Recipients: A Systematic Review and Meta-Analysis of Real-World Studies.Journal of clinical medicine · 2026Pooled it
- Prevalence of HIV and hepatitis B co-infection in Nigeria: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- Estimates of the global prevalence of occult hepatitis B virus infection in population under 18 years old: a systematic review and meta-analysis.Hepatology international · 2025Pooled it
- Seroprevalence of human immunodeficiency virus in African blood donors: a systematic review and meta-analysis.EBioMedicine · 2024Pooled it
- Occult hepatitis B virus infection.Nature reviews. Gastroenterology & hepatology · 2026Review
- The role of IL-6 -174C/G polymorphism in hepatitis B virus infection: a genetic association study.Journal, genetic engineering & biotechnology · 2026Article
- Article
- Occult hepatitis B and risk of reactivation following switch to non-hepatitis B virus-active antiretroviral therapy in people with HIV.AIDS (London, England) · 2026Review
- Etiology-Based Treatment for Unresectable/Advanced Hepatocellular Carcinoma: Focus on Viral Hepatitis and Metabolic Dysfunction-Associated Steatohepatitis.Liver cancer · 2026Review
- Serological and Demographic Correlates of HBV DNA Detection Below the Limit of Quantification in Treated Chronic Hepatitis B and HBsAg-Negative Patients.Biomedicines · 2026Article
- HBV biomarkers outperform host genetic variants in distinguishing occult HBV infection from chronic carriers.iScience · 2026Article
- Article
- Characteristics of occult hepatitis B infection among pregnant women in the Center Region of Cameroon: rationale for universal administration of hepatitis B birth dose vaccine.BMC pregnancy and childbirth · 2026Article
- Uncovering silent carriers: Hematological insights and viral burden in incidentally detected hepatitis B virus infection.World journal of hepatology · 2026Article
- Occult hepatitis B virus infection among hepatitis B surface antigen negative vaccinated healthcare workers in East Gojjam zone hospitals.Scientific reports · 2026Article
- Plasma exchange-based artificial liver support system demonstrates short-term therapeutic efficacy in treating chronic severe hepatitis B.American journal of translational research · 2026Article
- Rapid and reagent-free screening of occult hepatitis B virus infection based on plasma Vis-NIR spectral pattern recognition.Frontiers in bioengineering and biotechnology · 2026Article
- The immunoecology of occult hepatitis B virus infection: genetic remodeling and the immune-mediated microcosm.Frontiers in immunology · 2026Review
- Isolated Anti-HBc in People Living with HIV: A 20-Year Experience from Istanbul, Turkey.Current HIV research · 2026Article
- Complete Genome Sequencing of Occult Hepatitis B Virus in Hemodialysis Patients Reveals Subgenotype D2 and Immune Escape Mutations in Bangladesh.International journal of microbiology · 2026Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite growing concerns about transmissibility and clinical impact, occult hepatitis B virus (HBV) infection has received little attention in the hepatitis elimination agenda. We aimed to estimate the prevalence of occult HBV infection at a global and regional scale and in specific populations.
methodsFor this systematic review and meta-analysis, we searched the MEDLINE, Embase, Global Health, and Web of Science databases for articles published in any language between Jan 1, 2010, and Aug 14, 2019. We included original articles and conference abstracts of any study design that reported the proportion of HBsAg-negative adults (aged ≥18 years) who are positive for HBV DNA (ie, people with occult HBV infection). The prevalence of occult HBV infection was pooled, using the DerSimonian-Laird random-effects model, in the general population and specific groups defined by the type of study participants (blood donors; other low-risk populations; high-risk populations; and people with advanced chronic liver disease), and stratified by HBV endemicity in each country. We also assessed the performance of anti-HBc as an alternative biomarker to detect occult HBV infection. The study was registered with PROSPERO, CRD42019115490.
findings305 of 3962 articles were eligible, allowing a meta-analysis of 140 521 993 individuals tested for HBV DNA. Overall, only two studies evaluated occult HBV infection in the general population, precluding unbiased global and regional estimates of occult HBV infection prevalence. In blood donors, occult HBV infection prevalence mirrored HBV endemicity: 0·06% (95% CI 0·00-0·26) in low-endemicity countries, 0·12% (0·04-0·23) in intermediate-endemicity countries, and 0·98% (0·44-1·72), in high-endemicity countries (p=0·0012). In high-risk groups, occult HBV infection prevalence was substantial, irrespective of endemicity: 5·5% (95% CI 2·9-8·7) in low-endemicity countries, 5·2% (2·5-8·6) in intermediate-endemicity countries, and 12·0% (3·4-24·7) in high-endemicity countries. The pooled sensitivity of anti-HBc to identify occult HBV infection was 77% (95% CI 62-88) and its specificity was 76% (68-83).
interpretationA substantial proportion of people carry occult HBV infection, especially among high-risk groups across the globe and people living in highly endemic countries. Occult HBV infection should be part of the global viral hepatitis elimination strategy.
fundingNone.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.