Occult hepatitis B virus infection and its clinical implications

被引:234
作者
Hu, KQ
机构
[1] Loma Linda Univ, Med Ctr, Inst Transplantat, Loma Linda, CA 92354 USA
[2] Loma Linda Univ, Med Ctr, Div Gastroenterol, Loma Linda, CA 92354 USA
[3] Jerry L Pettis Mem Vet Adm Med Ctr, Loma Linda, CA 92354 USA
关键词
chronic hepatitis B; chronic hepatitis C; HBV replication; hepatitis B virus; hepatitis C virus; hepatocellular carcinoma; occult HBV infection;
D O I
10.1046/j.1365-2893.2002.00344.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Occult hepatitis B virus (HBV) infection is characterized by presence of HBV infection with undetectable hepatitis B surface antigen (HBsAg). Serum HBV level is usually less than 10(4) copies/mL in these patients. Diagnosis of occult HBV infection requires sensitive HBV-DNA PCR assay. Several possibilities have been hypothesized as the mechanisms of occult HBV infection. These include: (i) mutations of HBV-DNA sequence; (ii) integration of HBV-DNA into host's chromosomes; (iii) infection of peripheral blood mononuclear cells by HBV; (iv) formation of HBV-containing immune complex; (v) altered host immune response; and (vi) interference of HBV by other viruses. The precise prevalence of occult HBV infection remains to be defined. The clinical implications of occult HBV infection involve different clinical aspects. First of all, occult HBV infection harbours potential risk of HBV transmission through blood transfusion, haemodialysis, and organ transplantation. Second, it may serve as the cause of cryptogenic liver disease, contribute to acute exacerbation of chronic hepatitis B, or even fulminant hepatitis. Third, it is associated with development of hepatocellular carcinoma. Fourth, it may affect disease progression and treatment response of chronic hepatitis C. Most of the previous studies utilized retrospective observation without control groups, and lacked direct association of occult HBV infection with specific pathological changes and disease progression. Highly sensitive, quantitative, and functional molecular analyses of HBV, combined with a well-designed prospective clinical assessment will provide the best approach for the future study of occult HBV infection.
引用
收藏
页码:243 / 257
页数:15
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