Occult hepatitis B virus infection (OBI) is a challenging clinical entity. It is defined as the presence of viral DNA in the liver or serum of subjects who test negative for the hepatitis B surface antigen. Molecular evidence of OBI consists of covalently closed circular DNA persisting in the nuclei of hepatocytes after infection. Immunocompetent individuals have a lower risk of complications than immunosuppressed subjects. However, under certain scenarios, OBI acquires clinical manifestations that include transmission of the infection via blood or organ transplantation, chronic liver disease progression, hepatocellular carcinoma, and virus reactivation when a state of immunosuppression develops. This review updates the clinical aspects of the diagnosis and management of OBI.
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