Altınbaş Akif, Ergünay Koray, Calık Başaran Nursel, Alp Alpaslan, Turgut Didem, Hasçelik Gülşen, Uzun Ömrüm, Unal Serhat
Hacettepe University Faculty of Medicine, Department of Internal Medicine, Ankara, Turkey.
Mikrobiyol Bul. 2011 Apr;45(2):353-8.
Due to their shared transmission route, hepatitis B virus (HBV) or hepatitis C virus (HCV) co-infections can be observed in human immunodeficiency virus (HIV)-infected cases and are associated with more severe clinical courses. The detection of HBV DNA despite HBV surface antigen (HBsAg) seronegativity is defined as occult HBV infections. According to the current seroepidemiological data, Turkey is classified as an intermediate HBV, low HIV endemic region. Occult HBV infections have previously been reported from Turkey but has not been investigated previously in HIV infected cohorts. The aim of this study was to identify occult HBV infections in HIV-infected persons. Twenty-eight HIV-positive cases followed-up at Hacettepe University Hospital, Infectious Diseases Unit were included in the study after informed consent. For the detection of HBsAg, anti-HBs and anti-HCV, commercial ELISA tests (Architect System, Abbott Diagnostics, USA) were employed. Absolute CD4+ and CD8+ T-cell counts were determined via flow cytometry. HIV viral load was calculated via COBAS TaqMan HIV-1 Real-time PCR (Roche Diagnostics, USA) and the presence of HBV DNA was evaluated via COBAS TaqMan HBV Real-time PCR (Roche Diagnostics, USA), in addition to a nested PCR assay targeting HBV S gene. The mean age of the study group was 43.2 (range between 27-65) years, 64.3% (18/28) of them were males and the mean duration of HIV infection was 4.2 (2-11) years. Mean CD4+ ve CD8+ T-cell counts were 414 ± 267 cells/mm3 and 854 ± 293 cells/mm3, respectively. Twenty-six (92.8%) cases were under highly-active anti-retroviral therapy at the time of the study, 88.5% of which included HBV-active drugs (lamivudine or tenofovir). HIV RNA were found negative in 11 (39.3%) patients, of those nine (81.8%) were the cases who treated with HBV-active antiretroviral therapy. HBsAg were negative in all of the 28 patients, while the positivity rates of anti-HBs and anti-HCV were 39.3% (11/28) and 3.6% (1/28), respectively. All samples were negative for HBV DNA via the commercial real-time PCR and in-house nested PCR assays. The absence of occult HBV in the study group may indicate the absence of occult HBV or suppression of viral replication due to the anti-retroviral therapy. In conclusion, further large-scale studies are required to fully understand the impact of occult HBV in HIV-infected patients in Turkey.
由于传播途径相同，在人类免疫缺陷病毒（HIV）感染病例中可观察到乙型肝炎病毒（HBV）或丙型肝炎病毒（HCV）合并感染，且与更严重的临床病程相关。尽管乙肝表面抗原（HBsAg）血清学检测呈阴性，但检测到HBV DNA被定义为隐匿性HBV感染。根据目前的血清流行病学数据，土耳其被归类为HBV中度流行、HIV低度流行地区。此前土耳其曾报告过隐匿性HBV感染，但此前尚未在HIV感染队列中进行过调查。本研究的目的是确定HIV感染者中的隐匿性HBV感染。在获得知情同意后，纳入了在哈杰泰佩大学医院传染病科接受随访的28例HIV阳性病例。采用商业酶联免疫吸附试验（Architect系统，美国雅培诊断公司）检测HBsAg、抗-HBs和抗-HCV。通过流式细胞术测定绝对CD4+和CD8+ T细胞计数。通过COBAS TaqMan HIV-1实时荧光定量PCR（美国罗氏诊断公司）计算HIV病毒载量，并通过COBAS TaqMan HBV实时荧光定量PCR（美国罗氏诊断公司）评估HBV DNA的存在情况，此外还采用了针对HBV S基因的巢式PCR检测方法。研究组的平均年龄为43.2岁（范围在27 - 65岁之间），其中64.3%（18/28）为男性，HIV感染的平均病程为4.2年（2 - 11年）。CD4+和CD8+ T细胞的平均计数分别为414 ± 267个细胞/mm3和854 ± 293个细胞/mm3。在研究时，26例（92.8%）病例正在接受高效抗逆转录病毒治疗，其中88.5%的治疗方案中包含抗HBV活性药物（拉米夫定或替诺福韦）。11例（39.3%）患者的HIV RNA检测呈阴性，其中9例（81.
