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标题: 隐匿性乙型肝炎病毒感染:具有新型临床参与的老实体。 [打印本页]

作者: StephenW    时间: 2018-10-18 09:02     标题: 隐匿性乙型肝炎病毒感染:具有新型临床参与的老实体。

Open Forum Infect Dis. 2018 Sep 14;5(10)fy227. doi: 10.1093/ofid/ofy227. eCollection 2018 Oct.
Occult Hepatitis B Virus Infection: An Old Entity With Novel Clinical Involvements.
Malagnino V1, Fofana DB2, Lacombe K1,3, Gozlan J2,4.
Author information

1
    Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, AP-HP, Paris, France.
2
    Laboratoire de Virologie, Hôpital Saint-Antoine, AP-HP, Paris, France.
3
    Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, F75012, Paris, France.
4
    UPMC UMRS CR7, INSERM U1135 CIMI, Paris, France.

Abstract
Background:

Occult hepatitis B infection (OBI) is recognized as a risk factor for cirrhosis and hepato-cellular carcinoma. However, OBI brings together a large spectrum of patients who might harbor different characteristics and prognosis.
Methods:

We analyzed the databases of a university hospital in Paris to identify OBI among patients (n = 3966) concomitantly tested for hepatitis B virus (HBV) DNA and serology during a 7-year period. OBI patients were gathered into clinical entities according to their clinical records.
Results:

Forty-seven OBIs were identified (1.2%). All patients had detectable anti-HBc, isolated (n = 26) or associated with anti-HBs (n = 21). The proportion of OBIs was 3.4% for patients with isolated anti-HBc and 4.2% for patients with both anti-HBc and anti-HBs. Four clinical categories of OBI patients were identified: patients with a passed HBV infection with HBs Ag clearance (group A, 23.4%); HBV-exposed patients receiving immunosuppressive therapy (group B, 29.8%); HIV/HBV-coinfected patients with therapy discontinuation (group C, 17%); HBV-exposed patients with severe liver conditions (group D, 29.8%). Significant follow-up was available for 32 patients, showing a more deleterious prognosis in group D patients, associated more with their underlying condition than the OBI status.
Conclusions:

OBI is a heterogeneous condition with various clinical implications.
KEYWORDS:

hepatitis B virus; immunosuppression; occult B infection

PMID:
    30324127
PMCID:
    PMC6180285
DOI:
    10.1093/ofid/ofy227
作者: StephenW    时间: 2018-10-18 09:02

Open Forum Infect Dis。 2018年9月14日; 5(10):ofy227。 doi:10.1093 / ofid / ofy227。 eCollection 2018年10月
隐匿性乙型肝炎病毒感染:具有新型临床参与的老实体。
Malagnino V1,Fofana DB2,Lacombe K1,3,Gozlan J2,4。
作者信息

1
    Service des Maladies Infectieuses et Tropicales,HôpitalSaint-Antoine,AP-HP,Paris,France。
2
    Laboratoire de Virologie,HôpitalSaint-Antoine,AP-HP,巴黎,法国。
3
    SorbonneUniversité,INSERM,Institut Pierre Louis d'EpidémiologieetdeSantéPubliqueIPLESP,F75012,Paris,France。
4
    UPMC UMRS CR7,INSERM U1135 CIMI,巴黎,法国。

抽象
背景:

隐匿性乙型肝炎感染(OBI)被认为是肝硬化和肝细胞癌的危险因素。然而,OBI汇集了大量可能具有不同特征和预后的患者。
方法:

我们分析了巴黎一所大学医院的数据库,以确定患者(n = 3966)中的OBI,同时测试了7年期间的乙型肝炎病毒(HBV)DNA和血清学。根据临床记录将OBI患者聚集到临床实体中。
结果:

确定了47个OBI(1.2%)。所有患者均可检出抗-HBc,分离(n = 26)或与抗-HBs相关(n = 21)。对于分离的抗HBc患者,OBI的比例为3.4%,对于抗HBc和抗HBs的患者,OBI的比例为4.2%。确定了四种临床类型的OBI患者:HBs Ag感染HBV感染的患者(A组,23.4%);暴露于HBV的患者接受免疫抑制治疗(B组,29.8%);停止治疗的HIV / HBV合并感染患者(C组,17%);接触HBV的严重肝病患者(D组,29.8%)。对32名患者进行了大量随访,显示D组患者的预后更为有害,其基础状况与OBI状态相关。
结论:

OBI是一种具有各种临床意义的异质性疾病。
关键词:

乙型肝炎病毒;免疫抑制;隐匿性B感染

结论:
    30324127
PMCID:
    PMC6180285
DOI:
    10.1093 / OFID / ofy227





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