Bae Eunsin, Park Chang-Hun, Ki Chang-Seok, Kim Sung-Joo, Huh Wooseong, Oh Ha-Young, Kang Eun-Suk
Department of Laboratory Medicine, Central Veterans Hospital, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, Korea.
Scand J Infect Dis. 2012 Oct;44(10):788-92. doi: 10.3109/00365548.2012.680488. Epub 2012 Jun 10.
Occult hepatitis B infection (OBI) is the presence of hepatitis B virus (HBV) DNA in serum or hepatic tissue without detectable hepatitis B surface antigen (HBsAg) in serum. Kidney disease patients in the post-renal transplantation period are in a specific situation as a result of the high pre-transplantational risk of HBV infection and post-transplantational immunosuppression. We studied the pre-transplantational prevalence and post-transplantational influence of OBI on kidney transplantation patients.
We investigated pre-transplantational serum samples of 217 HBsAg-negative patients of post-renal transplant status for the presence of HBV DNA by real-time quantitative polymerase chain reaction. Serologic markers for HBV and hepatitis C virus (HCV) infection as well as liver enzymes were analyzed.
We detected HBV DNA in 2.3% (5/217) of HBsAg-negative patients, and the median HBV DNA titer was 33.15 copies/ml (range 30.6-144.6 copies/ml). Among the 5 OBI patients, 2 had hepatitis B surface antibodies (anti-HBs) and 1 had hepatitis B core antibodies (anti-HBc IgG). None of the patients with OBI were co-infected with HCV. There was no evidence of reactivation of OBI during the 36-month (range 27-63 months) follow-up monitoring period after transplantation, in spite of immune suppression to prevent rejection.
The prevalence of occult HBV in the setting of renal transplantation was higher than that in the general population of Korea, and no reactivation of hepatitis B was observed in patients with OBI in the post-renal transplantation period.
隐匿性乙型肝炎感染（OBI）是指血清或肝组织中存在乙型肝炎病毒（HBV）DNA，但血清中检测不到乙型肝炎表面抗原（HBsAg）。肾移植术后患者由于移植前HBV感染风险高以及移植后免疫抑制而处于特殊情况。我们研究了OBI在肾移植患者中的移植前患病率及其移植后的影响。
我们通过实时定量聚合酶链反应研究了217例肾移植术后HBsAg阴性患者的移植前血清样本中HBV DNA的存在情况。分析了HBV和丙型肝炎病毒（HCV）感染的血清学标志物以及肝酶。
我们在2.3%（5/217）的HBsAg阴性患者中检测到HBV DNA，HBV DNA滴度中位数为33.15拷贝/毫升（范围为30.6 - 144.6拷贝/毫升）。在5例OBI患者中，2例有乙型肝炎表面抗体（抗-HBs），1例有乙型肝炎核心抗体（抗-HBc IgG）。所有OBI患者均未合并HCV感染。尽管进行了免疫抑制以预防排斥反应，但在移植后的36个月（范围为27 - 63个月）随访监测期内，没有证据表明OBI重新激活。
肾移植患者中隐匿性HBV的患病率高于韩国普通人群，肾移植术后OBI患者未观察到乙型肝炎重新激活。
