Alencar R S M, Gomes M M S, Sitnik R, Pinho J R R, Malta F M, Mello I M V G C, Mello E S, Bacchella T, Machado M C C, Alves V A F, Carrilho F J
Departamento de Gastroenterologia, Universidade de São Paulo, Brasil.
Braz J Med Biol Res. 2008 Mar;41(3):235-40. doi: 10.1590/s0100-879x2006005000197. Epub 2007 Nov 29.
Occult hepatitis B virus (HBV) infection has been reported among patients with hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC). Our aim was to evaluate the presence of occult HBV infection in patients with HCV-related liver cirrhosis (LC) with or without HCC in São Paulo, Brazil. Serum and liver tissue samples from 50 hepatitis B surface antigen-negative patients with HCV-related LC who underwent liver transplantation at the University of São Paulo School of Medicine Hospital from 1993 to 2004 were divided into groups with LC only (N = 33) and with LC plus HCC (N = 17). HBV DNA was assayed for serum and paraffin-embedded liver tissue (tumoral and non-tumoral) using real time PCR and only 1 case with HCC had HBV DNA-positive serum. All liver samples were negative. HCV genotype 3 was detected in 17/39 (43.7%) cases. In conclusion, using a sensitive real time PCR directed to detect HBV variants circulating in Brazil, occult hepatitis B infection was not found among HCV-positive cirrhotic patients and was rarely found among HCV-positive HCC patients. These results are probably related to the low prevalence of HBV infection in our population. Furthermore, we have also shown that HCV genotype 3 is frequently found in Brazilian cirrhotic patients, particularly when they also have HCC. More studies involving a large number of cases should be carried out to confirm these data and to further characterize Brazilian HCV genotype isolates to elucidate genetic features that might be related to its carcinogenic potential.
据报道，丙型肝炎病毒（HCV）感染患者和肝细胞癌（HCC）患者中存在隐匿性乙型肝炎病毒（HBV）感染。我们的目的是评估巴西圣保罗患有或未患有HCC的HCV相关性肝硬化（LC）患者中隐匿性HBV感染的情况。1993年至2004年在圣保罗大学医学院医院接受肝移植的50例HBsAg阴性的HCV相关性LC患者的血清和肝组织样本被分为单纯LC组（N = 33）和LC合并HCC组（N = 17）。使用实时PCR检测血清和石蜡包埋的肝组织（肿瘤和非肿瘤）中的HBV DNA，只有1例HCC患者血清HBV DNA呈阳性。所有肝组织样本均为阴性。在17/39（43.7%）的病例中检测到HCV基因型3。总之，使用针对检测巴西流行的HBV变异体的敏感实时PCR，在HCV阳性肝硬化患者中未发现隐匿性乙型肝炎感染，在HCV阳性HCC患者中也很少发现。这些结果可能与我们人群中HBV感染的低患病率有关。此外，我们还表明，HCV基因型3在巴西肝硬化患者中经常发现，特别是当他们也患有HCC时。应该进行更多涉及大量病例的研究来证实这些数据，并进一步对巴西HCV基因型分离株进行特征分析，以阐明可能与其致癌潜力相关的遗传特征。
