隐匿性乙型肝炎病毒感染：具有新型临床参与的老实体。

StephenW

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

StephenW

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