Setúbal Hospital Center, Setúbal, Portugal.
Eur J Gastroenterol Hepatol. 2013 Feb;25(2):142-6. doi: 10.1097/MEG.0b013e328359fe54.
Occult hepatitis B virus (HBV) infection, defined as the presence of HBV DNA in the liver (with detectable or undetectable HBV DNA in the serum), has been reported in patients with chronic hepatitis C. Some data suggest its association with a more severe liver disease and a worse response to interferon therapy in this subgroup of patients. However, the clinical significance of this condition is still under debate.
To determine the prevalence of occult HBV infection and its clinical significance in patients with chronic hepatitis C liver disease.
A prospective analysis of consecutive outpatients with chronic hepatitis C who underwent a liver biopsy recruited between January 2008 and June 2011 was carried out. Data included patient's sex and age, source of hepatitis C virus (HCV) infection, HCV genotype and viral load, presence of serologic markers of previous HBV infection, HBV DNA presence in the liver, histologic findings, and response to interferon and ribavirin treatment. HBV DNA and HCV RNA detection were carried out using a sensitive commercially available PCR kit. HBV DNA was tested in liver samples using a nested PCR procedure.
One hundred patients were included, 73% men, mean age 49 ± 11.9 years. Most patients had a genotype 1, with a high viral load, HCV infection. Of the patients, 33% had HBV serologic markers of past infection. The presence of HBV DNA in liver samples was found in 57% of the patients. No statistically significant difference in the epidemiological, histological, or virological or response to therapy data was found in patients with occult HBV infection.
Occult HBV infection occurred in a high percentage of patients but was not clinically significant.
隐匿性乙型肝炎病毒（HBV）感染定义为血清中 HBV DNA 检测不到或检测到 HBV DNA，但肝组织中存在 HBV DNA，已在慢性丙型肝炎患者中报道。一些数据表明，隐匿性 HBV 感染与该亚组患者更严重的肝病和干扰素治疗反应较差有关。然而，这种情况的临床意义仍存在争议。
确定隐匿性 HBV 感染在慢性丙型肝炎肝病患者中的流行率及其临床意义。
对 2008 年 1 月至 2011 年 6 月期间连续进行肝活检的慢性丙型肝炎门诊患者进行前瞻性分析。数据包括患者的性别和年龄、丙型肝炎病毒（HCV）感染来源、HCV 基因型和病毒载量、既往 HBV 感染血清学标志物的存在、肝内 HBV DNA 的存在、组织学发现以及干扰素和利巴韦林治疗的反应。使用敏感的商业 PCR 试剂盒检测 HBV DNA 和 HCV RNA。使用巢式 PCR 程序检测肝组织中的 HBV DNA。
共纳入 100 例患者，其中 73%为男性，平均年龄为 49±11.9 岁。大多数患者为基因型 1，病毒载量高，HCV 感染。其中 33%的患者有 HBV 既往感染的血清学标志物。57%的患者肝组织中存在 HBV DNA。在隐匿性 HBV 感染患者中，在流行病学、组织学、病毒学或治疗反应数据方面未发现统计学显著差异。
隐匿性 HBV 感染在很大比例的患者中发生，但无临床意义。
