Yes, occult hepatitis B infection (OBI) can accelerate liver fibrosis progression and increase the risk of developing hepatocellular carcinoma (HCC). This risk is pronounced in patients with other chronic liver diseases, including hepatitis C or cirrhosis. OBI maintains pro-oncogenic potential similar to overt HBV infection, contributing to persistent liver inflammation and carcinogenesis
Yes, The DNA of HBV is still there and replicating in low levels, only HBsAg negative, so genetic integration and genome instability were ongoing, predisposing to HCC.
Clinically, a good study done in a cohort base design they found significant association with Occult compared to overt chroni HBV infection , in liver cirrhosis and HCC (Squadrido, 2006).