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隐匿性乙型肝炎:临床观点与管理

Occult hepatitis B: clinical viewpoint and management.

作者信息

Zobeiri Mehdi

机构信息

Internal Medicine Department, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Hepat Res Treat. 2013;2013:259148. doi: 10.1155/2013/259148. Epub 2013 Mar 4.

Abstract

Occult HBV infection (OBI) is defined as HBV DNA detection in serum or in the liver by sensitive diagnostic tests in HBsAg-negative patients with or without serologic markers of previous viral exposure. OBI seems to be higher among subjects at high risk for HBV infection and with liver disease. OBI can be both a source of virus contamination in blood and organ donations and the reservoir for full blown hepatitis after reactivation. HBV reactivation depends on viral and host factors but these associations have not been analyzed thoroughly. In OBI, it would be best to prevent HBV reactivation which inhibits the development of hepatitis and subsequent mortality. In diverse cases with insufficient data to recommend routine prophylaxis, early identification of virologic reactivation is essential to start antiviral therapy. For retrieving articles regarding OBI, various databases, including OVID, PubMed, Scopus, and ScienceDirect, were used.

摘要

隐匿性乙型肝炎病毒感染(OBI)的定义为,在HBsAg阴性、有或无既往病毒暴露血清学标志物的患者中,通过敏感诊断检测在血清或肝脏中检测到HBV DNA。在乙型肝炎病毒感染高危和患有肝病的人群中,隐匿性乙型肝炎病毒感染似乎更为常见。隐匿性乙型肝炎病毒感染既可能是血液和器官捐献中病毒污染的来源,也可能是病毒再激活后发生严重肝炎的病毒储存库。乙肝病毒再激活取决于病毒和宿主因素,但这些关联尚未得到充分分析。对于隐匿性乙型肝炎病毒感染,最好预防乙肝病毒再激活,因为这可以抑制肝炎的发展及随后的死亡率。在缺乏足够数据推荐常规预防措施的各种情况下,早期识别病毒学再激活对于启动抗病毒治疗至关重要。为检索有关隐匿性乙型肝炎病毒感染的文章,我们使用了包括OVID、PubMed、Scopus和ScienceDirect在内的各种数据库。

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