Abstract

After recovery from a hepatitis B virus (HBV) infection, reactivation can occur with immunosuppression; thus, it is assumed that replication competent HBV persists in the liver. We sought to detect persistent HBV from 13 people with spontaneous recovery. We quantified HBV DNA and RNA in core liver biopsy specimens (median, 1.72 × 106 cells) from persons who inject drugs. Of 13 biopsy specimens, 8 (61%) had evidence of HBV DNA or RNA and 5 (38%) had both HBV DNA and RNA. Messenger RNAs were derived from covalently closed circular DNA and integrated HBV DNA. Here, we show prevalent HBV DNA and RNA despite clinical recovery in persons who inject drugs.

Lay Summary

We used a sensitive method to determine the amount of hepatitis B virus (HBV) DNA or RNA in the livers of 13 individuals who recovered from HBV infection. We found viral DNA or RNA in 8 biopsy specimens (61%) despite no detectable virus in blood, showing that eliminating all hepatitis B from the liver is a difficult treatment goal.

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