Ramia S, Sharara A I, El-Zaatari M, Ramlawi F, Mahfoud Z
Department of Medical Laboratory Technology, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Eur J Clin Microbiol Infect Dis. 2008 Mar;27(3):217-21. doi: 10.1007/s10096-007-0429-7.
Occult hepatitis B virus (HBV) infection, characterised by the presence of HBV infection with undetectable hepatitis B surface antigen (HBsAg), was investigated in 98 Lebanese patients with chronic hepatitis C liver disease and 85 control subjects recruited from eight institutions in different parts of the country. The prevalence of occult HBV infection ranged from 11.9% to 44.4% in hepatitis C virus (HCV)-infected patients and it increased with increasing severity of the liver disease. The overall rate of HBV DNA in our 98 HCV-infected patients was 16.3%. On the other hand, the rate of HBV DNA was 41.0% in anti-HBc alone positive patients compared to only 7.1% in healthy controls who were also anti-HBc alone positive (p < 0.001). Moreover, the prevalence HBV DNA increased with increasing severity of the liver disease, but this increase was only marginally significant and, perhaps, could have been significant if more patients were involved in the study. Although Lebanon is an area of low endemicity for both HBV and HCV, occult HBV infection is common in HCV-infected patients. The presence of HBV DNA, therefore, presents a challenge for the effective laboratory diagnosis of hepatitis B, particularly if polymerase chain reaction (PCR)-based HBV detection methods are not used.
对98例黎巴嫩慢性丙型肝炎肝病患者和85名对照者进行了隐匿性乙型肝炎病毒（HBV）感染的调查，这些对照者来自该国不同地区的8个机构。隐匿性HBV感染的特征是存在HBV感染但检测不到乙型肝炎表面抗原（HBsAg）。丙型肝炎病毒（HCV）感染患者中隐匿性HBV感染的患病率在11.9%至44.4%之间，并且随着肝病严重程度的增加而升高。在我们的98例HCV感染患者中，HBV DNA的总体检出率为16.3%。另一方面，仅抗-HBc阳性患者中HBV DNA的检出率为41.0%，而同样仅抗-HBc阳性的健康对照者中该检出率仅为7.1%（p<0.001）。此外，HBV DNA的患病率随着肝病严重程度的增加而升高，但这种升高仅略有统计学意义，并且如果有更多患者参与该研究，可能会具有统计学意义。尽管黎巴嫩是HBV和HCV低流行地区，但隐匿性HBV感染在HCV感染患者中很常见。因此，HBV DNA的存在对乙型肝炎的有效实验室诊断提出了挑战，特别是如果不使用基于聚合酶链反应（PCR）的HBV检测方法。
