{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T20:01:05Z","timestamp":1772740865765,"version":"3.50.1"},"reference-count":88,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Occult hepatitis B infection (OBI) is a significant issue in high-risk groups, including drug users. Therefore, the present study was conducted to assess the prevalence of OBI among drug users in Fars Province in 2024. In this cross-sectional study, 460 hepatitis B surface antigen (HBsAg)-negative individuals with a history of drug addiction were included. A questionnaire was completed for each participant to collect demographic, social, and behavioral information. Hepatitis B core antibody (anti-HBc) was assessed using an ELISA. Total DNA from serum samples that tested positive for anti-HBc was extracted and tested for hepatitis B virus DNA (HBV-DNA) using quantitative polymerase chain reaction (qPCR) testing. Moreover, peripheral blood mononuclear cells (PBMCs) were separated using the Ficoll gradient method, and their DNA was extracted, followed by qPCR testing. The mean age of the participants was 44.1 years (SD = 11.2; range: 13\u201385 years), whereas the mean age of anti-HBc-positive individuals was 51.2 years (SD = 9.2; range: 24\u201372 years). Among the participants, 82.6% were male. The frequency of anti-HBc was 15%, and it was significantly associated with age, history of injection drug use, medical service utilization, anti-hepatitis C virus positivity, HIV status, national hepatitis B vaccination time, and city of residence. No significant association was observed among sex, marital status, tattooing, or unsafe sexual practices. A qPCR analysis revealed undetectable HBV-DNA in all 64 serum samples of anti-HBc-positive subjects, whereas 1 out of 14 PBMC samples (7.1%) was positive for HBV-DNA. A 15% prevalence rate for resolved HBV infection was indicated in the present study, with no evidence of OBI in serum samples and a very low frequency of OBI in PBMCs.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0099","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T14:52:12Z","timestamp":1768315932000},"page":"531-535","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of Hepatitis B Core Antibody and Occult Hepatitis B Infection among Drug Users in Fars Province, Southwestern Iran, 2024"],"prefix":"10.4269","volume":"114","author":[{"given":"Zahra","family":"Amiri","sequence":"first","affiliation":[{"name":"Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;"},{"name":"Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aboulfazl","family":"Gheshlaghi","sequence":"additional","affiliation":[{"name":"Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyed Mohammad Ali","family":"Hashemi","sequence":"additional","affiliation":[{"name":"Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afagh","family":"Moattari","sequence":"additional","affiliation":[{"name":"Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amin","family":"Ramezani","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnology, School of Advanced Medical Sciences and Technology, Shiraz University of Medical Sciences, Shiraz, Iran;"},{"name":"Institute for Cancer Research, Shiraz University of Medical sciences, Shiraz, Iran;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyed Younes","family":"Hosseini","sequence":"additional","affiliation":[{"name":"Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamal","family":"Sarvari","sequence":"additional","affiliation":[{"name":"Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;"},{"name":"Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet Gastroenterol Hepatol","first-page":"383","article-title":"Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: A modelling study","volume":"3","year":"2018"},{"key":"b2","series-title":"Am J Trop Med Hyg","first-page":"174","article-title":"Occult hepatitis B virus infection among \u03b2-thalassemia major patients in Ahvaz City, Iran","volume":"106","author":"Amirhashchi","year":"2021"},{"key":"b3","series-title":"Arch Iran Med","first-page":"501","article-title":"Prevalence of hepatitis B and C among drug-abusing male prisoners in Birjand, South Khorasan, Iran","volume":"22","author":"Ghafari","year":"2019"},{"key":"b4","series-title":"Antiviral Res","first-page":"104925","article-title":"Hepatitis B virus biology and life cycle","volume":"182","author":"Tsukuda","year":"2020"},{"key":"b5","series-title":"J Egypt Public Health Assoc","first-page":"13","article-title":"Prevalence of occult hepatitis B virus infection in Egypt: A systematic review with meta-analysis","volume":"98","author":"Azzam","year":"2023"},{"key":"b6","series-title":"Nat Rev Dis Primers","first-page":"18035","article-title":"Hepatitis B virus infection","volume":"4","author":"Yuen","year":"2018"},{"key":"b7","series-title":"Iran J Microbiol","first-page":"410","article-title":"Prevalence of occult hepatitis B virus infection among blood donors in Golestan province: Cross-sectional study","volume":"14","author":"Bahrami","year":"2022"},{"key":"b8","series-title":"Front Cell Infect Microbiol","first-page":"1186877","article-title":"High-sensitivity HBV DNA test for the diagnosis of occult HBV infection: Commonly used but not reliable","volume":"13","author":"Wang","year":"2023"},{"key":"b9","series-title":"Int J Cancer Manag","first-page":"e137093","article-title":"Molecular investigation of occult hepatitis B virus infection among patients with liver cancers","volume":"16","author":"Javanmard","year":"2023"},{"key":"b10","series-title":"Adv Biomed Res","first-page":"17","article-title":"The prevalence of isolated hepatitis B core antibody and its related risk factors among male injected drug users in Isfahan prisons","volume":"4","author":"Shirani","year":"2015"},{"key":"b11","series-title":"Mem Inst Oswaldo Cruz","first-page":"386","article-title":"Occult hepatitis B virus infection among injecting drug users in the Central-West Region of Brazil","volume":"108","author":"Matos","year":"2013"},{"key":"b12","series-title":"Lancet Gastroenterol Hepatol","first-page":"932","article-title":"Prevalence of occult hepatitis B virus infection in adults: A systematic review and meta-analysis","volume":"7","author":"Im","year":"2022"},{"key":"b13","series-title":"J Virus Erad","first-page":"100333","article-title":"Rate of occult hepatitis B virus infection among individuals with tuberculosis in northeastern Iran: A molecular epidemiological study","volume":"9","author":"Ghezeldasht","year":"2023"},{"key":"b14","series-title":"Rep Biochem Mol Biol","first-page":"38","article-title":"Occult hepatitis B demonstrated by anti-HBc and HBV DNA in HIV-positive patients","volume":"3","author":"Honarmand","year":"2014"},{"key":"b15","series-title":"Hepat Mon","first-page":"e101722","article-title":"Occult hepatitis B virus infection prevalence among different populations of Iran: A systematic review and meta-analysis","volume":"20","author":"Hedayati-Moghaddam","year":"2020"},{"key":"b16","series-title":"Health Sci Rep","first-page":"e1466","article-title":"Occult hepatitis B in Iranian blood donors, an overview of the challenges: A narrative review","volume":"6","author":"Ahmadi","year":"2023"},{"key":"b17","series-title":"Jundishapur J Microbiol","first-page":"e37329","article-title":"The prevalence of SEN virus and occult hepatitis B (OBI) virus infection among blood donors in Ahvaz city","volume":"9","author":"Abbasi","year":"2016"},{"key":"b18","series-title":"Arch Iran Med","first-page":"106","article-title":"Occult hepatitis B virus infection among Iranian blood donors: A preliminary 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Mon","first-page":"e34763","article-title":"Characterization of occult hepatitis B infection among injecting drug users in Tehran, Iran","volume":"16","author":"Asli","year":"2016"},{"key":"b24","series-title":"Semin Immunopathol","first-page":"39","article-title":"Occult HBV infection","volume":"35","author":"Raimondo","year":"2013"},{"key":"b25","series-title":"Viruses","first-page":"1504","article-title":"Occult hepatitis B virus infection: An update","volume":"14","author":"Saitta","year":"2022"},{"key":"b26","series-title":"World J Gastroenterol","first-page":"1563","article-title":"Management of occult hepatitis B virus infection: An update for the clinician","volume":"17","author":"Lled\u00f3","year":"2011"},{"key":"b27","series-title":"World J Gastroenterol","first-page":"8720","article-title":"Update on occult hepatitis B virus infection","volume":"22","author":"Makvandi","year":"2016"},{"key":"b28","series-title":"Hepatol Int","first-page":"503","article-title":"The 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lack of HBV DNA among HBsAg-negative blood donors in Iran: A cross-sectional study and review of literature","volume":"27","author":"Hedayati-Moghaddam","year":"2024"},{"key":"b33","series-title":"Electron Physician","first-page":"659","article-title":"Prevalence of HBc-Ab among HBs-Ag negative healthy blood donors in south of Iran","volume":"5","author":"Khorami","year":"2013"},{"key":"b34","series-title":"IJID Reg","first-page":"141","article-title":"Prevalence of occult hepatitis B virus infection among patients receiving haemodialysis in Sana\u2019a city","volume":"5","author":"Al-Masoodi","year":"2022"},{"key":"b35","series-title":"PLoS One","first-page":"e0205356","article-title":"Effectiveness of PCR primers for the detection of occult hepatitis B virus infection in Mexican patients","volume":"13","author":"Sosa-Jurado","year":"2018"},{"key":"b36","series-title":"Arch Clin Infect Dis","first-page":"e67968","article-title":"Prevalence and risk factors for occult hepatitis B and HIV infections among HCV infected intravenous drug users, Tehran, Iran","volume":"13","author":"Abadi","year":"2018"},{"key":"b37","series-title":"Sci Rep","first-page":"13188","article-title":"Occult hepatitis B virus infection among patients with chronic liver disease of unidentified cause, Addis Ababa, Ethiopia","volume":"12","author":"Gissa","year":"2022"},{"key":"b38","series-title":"Rep Biochem Mol Biol","first-page":"82","article-title":"Prevalence of occult hepatitis B virus infection in hemodialysis patients using nested PCR","volume":"9","author":"Samadi","year":"2020"},{"key":"b39","series-title":"Arch Pediatr Infect Dis","first-page":"e118763","article-title":"Screening of occult hepatitis B and C virus infection in working children, Tehran, Iran","volume":"10","author":"Marjani","year":"2022"},{"key":"b40","series-title":"Mod Care J","first-page":"e65546","article-title":"The prevalence of occult HBV infection among hemodialysis patients of Tehran, 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blood donors: Implications for transfusion practice","volume":"47","author":"Bhatti","year":"2007"},{"key":"b1","series-title":"Lancet Gastroenterol Hepatol","first-page":"383","article-title":"Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: A modelling study","volume":"3","year":"2018"},{"key":"b2","series-title":"Am J Trop Med Hyg","first-page":"174","article-title":"Occult hepatitis B virus infection among \u03b2-thalassemia major patients in Ahvaz City, Iran","volume":"106","author":"Amirhashchi","year":"2021"},{"key":"b3","series-title":"Arch Iran Med","first-page":"501","article-title":"Prevalence of hepatitis B and C among drug-abusing male prisoners in Birjand, South Khorasan, Iran","volume":"22","author":"Ghafari","year":"2019"},{"key":"b4","series-title":"Antiviral Res","first-page":"104925","article-title":"Hepatitis B virus biology and life cycle","volume":"182","author":"Tsukuda","year":"2020"},{"key":"b5","series-title":"J Egypt Public Health Assoc","first-page":"13","article-title":"Prevalence of occult hepatitis B virus infection in Egypt: A systematic review with meta-analysis","volume":"98","author":"Azzam","year":"2023"},{"key":"b6","series-title":"Nat Rev Dis Primers","first-page":"18035","article-title":"Hepatitis B virus infection","volume":"4","author":"Yuen","year":"2018"},{"key":"b7","series-title":"Iran J Microbiol","first-page":"410","article-title":"Prevalence of occult hepatitis B virus infection among blood donors in Golestan province: Cross-sectional study","volume":"14","author":"Bahrami","year":"2022"},{"key":"b8","series-title":"Front Cell Infect Microbiol","first-page":"1186877","article-title":"High-sensitivity HBV DNA test for the diagnosis of occult HBV infection: Commonly used but not reliable","volume":"13","author":"Wang","year":"2023"},{"key":"b9","series-title":"Int J Cancer Manag","first-page":"e137093","article-title":"Molecular investigation of occult hepatitis B virus infection among patients with liver cancers","volume":"16","author":"Javanmard","year":"2023"},{"key":"b10","series-title":"Adv Biomed Res","first-page":"17","article-title":"The prevalence of isolated hepatitis B core antibody and its related risk factors among male injected drug users in Isfahan prisons","volume":"4","author":"Shirani","year":"2015"},{"key":"b11","series-title":"Mem Inst Oswaldo Cruz","first-page":"386","article-title":"Occult hepatitis B virus infection among injecting drug users in the Central-West Region of Brazil","volume":"108","author":"Matos","year":"2013"},{"key":"b12","series-title":"Lancet Gastroenterol Hepatol","first-page":"932","article-title":"Prevalence of occult hepatitis B virus infection in adults: A systematic review and meta-analysis","volume":"7","author":"Im","year":"2022"},{"key":"b13","series-title":"J Virus Erad","first-page":"100333","article-title":"Rate of occult hepatitis B virus infection among individuals with tuberculosis in northeastern Iran: A molecular epidemiological study","volume":"9","author":"Ghezeldasht","year":"2023"},{"key":"b14","series-title":"Rep Biochem Mol Biol","first-page":"38","article-title":"Occult hepatitis B demonstrated by anti-HBc and HBV DNA in HIV-positive patients","volume":"3","author":"Honarmand","year":"2014"},{"key":"b15","series-title":"Hepat Mon","first-page":"e101722","article-title":"Occult hepatitis B virus infection prevalence among different populations of Iran: A systematic review and meta-analysis","volume":"20","author":"Hedayati-Moghaddam","year":"2020"},{"key":"b16","series-title":"Health Sci Rep","first-page":"e1466","article-title":"Occult hepatitis B in Iranian blood donors, an overview of the challenges: A narrative review","volume":"6","author":"Ahmadi","year":"2023"},{"key":"b17","series-title":"Jundishapur J Microbiol","first-page":"e37329","article-title":"The prevalence of SEN virus and occult hepatitis B (OBI) virus infection among blood donors in Ahvaz city","volume":"9","author":"Abbasi","year":"2016"},{"key":"b18","series-title":"Arch Iran Med","first-page":"106","article-title":"Occult hepatitis B virus infection among Iranian blood donors: A preliminary study","volume":"17","author":"Alizadeh","year":"2014"},{"key":"b19","series-title":"Iran J Immunol","first-page":"172","article-title":"Detection of HBV DNA in HBsAg negative normal blood donors","volume":"2","author":"Pourazar","year":"2005"},{"key":"b20","series-title":"Indian J Med Res","first-page":"37","article-title":"Anti-HBc & HBV-DNA detection in blood donors negative for hepatitis B virus surface antigen in reducing risk of transfusion-associated HBV infection","volume":"123","author":"Behzad-Behbahani","year":"2006"},{"key":"b21","series-title":"Iran J Blood Disord Transfus","first-page":"1","article-title":"Frequency of anti-HBc & HBV DNA detection in blood donors of Kerman province","volume":"2","author":"Delavari","year":"2011"},{"key":"b22","series-title":"Hepat Mon","first-page":"e6590","article-title":"Hepatitis B viral DNA among HBs antigen negative healthy blood donors","volume":"13","author":"Vaezjalali","year":"2013"},{"key":"b23","series-title":"Hepat Mon","first-page":"e34763","article-title":"Characterization of occult hepatitis B infection among injecting drug users in Tehran, Iran","volume":"16","author":"Asli","year":"2016"},{"key":"b24","series-title":"Semin Immunopathol","first-page":"39","article-title":"Occult HBV infection","volume":"35","author":"Raimondo","year":"2013"},{"key":"b25","series-title":"Viruses","first-page":"1504","article-title":"Occult hepatitis B virus infection: An update","volume":"14","author":"Saitta","year":"2022"},{"key":"b26","series-title":"World J Gastroenterol","first-page":"1563","article-title":"Management of occult hepatitis B virus infection: An update for the clinician","volume":"17","author":"Lled\u00f3","year":"2011"},{"key":"b27","series-title":"World J Gastroenterol","first-page":"8720","article-title":"Update on occult hepatitis B virus infection","volume":"22","author":"Makvandi","year":"2016"},{"key":"b28","series-title":"Hepatol Int","first-page":"503","article-title":"The prevalence of occult HBV infection in immunized children with HBsAg-positive parents: A hospital-based analysis","volume":"14","author":"Zhuge","year":"2020"},{"key":"b29","series-title":"Dig Dis Sci","first-page":"46","article-title":"Hepatitis B management in vulnerable populations: Gaps in disease monitoring and opportunities for improved care","volume":"59","author":"Burman","year":"2014"},{"key":"b30","series-title":"Infect Dis Ther","first-page":"871","article-title":"Effect of anti-HBs on mortality among resolved HBV infection: A population-based prospective cohort study","volume":"12","author":"Huang","year":"2023"},{"key":"b31","series-title":"Transfus Apher Sci","first-page":"195","article-title":"Frequency of hepatitis B virus DNA in anti-HBc 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