J Infect Dev Ctries. 2019 Mar 31;13(3):255-260. doi: 10.3855/jidc.9929.
Booster immunity - diagnosis of chronic hepatitis B viral infection.
Komitova RT1, Kevorkyan AK2, Atanasova MV3, Ivanova AV4, Golkocheva-Markova E5.
Author information
1
Department of Infectious diseases, Parasitology and Tropical medicine, Faculty of Medicine, Medical University, Plovdiv, Bulgaria. [email protected].
2
Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University, Plovdiv, Bulgaria. [email protected].
3
Department of Microbiology and Immunology, Faculty of Pharmacy, Medical University, Plovdiv, Bulgaria. [email protected].
4
Laboratory of Porphyrias and Molecular Diagnostics of Liver Diseases. Clinic of Gastroenterology, Saint Ivan Rilski University Hospital, Sofia, Bulgaria. [email protected].
5
National Reference Laboratory "Hepatitis viruses", National Center for Infectious and Parasitic Diseases, Sofia, Bulgaria. [email protected].
Abstract
INTRODUCTION:
Diagnosis of chronic hepatitis B virus (HBV) infection particularly its occult form requires monitoring and repeat serological and molecular studies. The aim of the study was to investigate the possible relation between the case of a family outbreak of hepatitis A and the finding that a member of this family was diagnosed with chronic hepatitis B.
METHODOLOGY:
A mother and her two sons, one previously diagnosed with chronic HBV infection, were hospitalized due to suspected acute hepatitis. Serological markers for hepatitis A, hepatitis B and hepatitis C were assessed. Additionally, HBV DNA was tested with a sensitive PCR. Hepatitis B vaccine was administered to the mother to differentiate resolved from occult HBV infection.
RESULTS:
A family outbreak of hepatitis A was confirmed, alongside a focus of chronic HBV infection. The serological profile for two brothers was HBsAg(+), anti-HBcIgM(-), anti-HBc(+), HBcAg(-)/anti-HBe(+). The mother was negative for all HBV markers except anti-HBc. HBV DNA was detected at a level of 461 IU/mL in the elder brother, 3647 IU/mL in the younger brother and was negative in the mother on two occasions. Her anti-HBc alone, having two sons with chronic HBV infection, and her lack of antibody response to hepatitis B vaccine despite being negative for HBV DNA, led to the diagnosis of probable occult HBV infection.
CONCLUSION:
Our results confirmed that a vaccination approach could facilitate diagnosis of chronic HBV infection in the presence of isolated anti-HBc. If it were not for a family outbreak of hepatitis A, this unexpected family HBV focus would not have been revealed.
Copyright (c) 2019 Radka T Komitova, Ani Kevorkyan, Maria Atanasova, Aneta Ivanova, Elica Golkocheva.
KEYWORDS:
anti-HBc alone; hepatitis B vaccine; hepatitis B virus; occult HBV infection
确认了家族性甲型肝炎暴发，以及慢性乙肝病毒感染的重点。两兄弟的血清学特征为HBsAg（+），抗HBcIgM（-），抗HBc（+），HBcAg（-）/抗HBe（+）。母亲对除抗HBc以外的所有HBV标记均为阴性。哥哥的HBV DNA水平为461 IU / mL，弟弟的水平为3647 IU / mL，母亲两次均呈阴性。她只有两个儿子患有慢性HBV感染，她仅抗HBc，尽管HBV DNA阴性，但她对乙型肝炎疫苗缺乏抗体反应，因此导致了可能的隐匿性HBV感染的诊断。
结论：