Vakili Ghartavol Zeinab, Alavian Seyed Moayed, Amini Safieh, Vahabpour Rouhollah, Bahramali Golnaz, Mostafavi Ehsan, Aghasadeghi Mohammad Reza
Department of Basic Sciences, Science and Research Branch, Islamic Azad University, Tehran, IR Iran.
Hepat Mon. 2013 May 29;13(5):e10134. doi: 10.5812/hepatmon.10134. eCollection 2013 May.
Occult hepatitis B virus (HBV) infection (OBI) is frequently reported in patients with chronic hepatitis C virus (HCV) infection. An association between OBI and more liver damage, cirrhosis, hepatocellular carcinoma, and reduced response to interferon therapy in patients with HCV infection is suggested.
The aim of this study was to determine the prevalence of occult HBV, and evaluate its clinical influence on patients with chronic HCV.
A cohort study including50 patients with positive results for HCV, and negative results for HBsAg tests was performed. The patients were divided into two groups: one group had positive results for both HCV and occult HBV tests (n = 18), and the other had positive results for HCV, but negative findings for occult HBV (n = 32). All were treated with PEG-IFN alpha-2a and Ribavirin. Presence of HCV RNA was followed in these patients.
HBV-DNA was detected using nested-PCR in 20% of plasma and 32.6% of peripheral blood mononuclear cell (PBMC) compartments. No significant differences were observed between patients with and without occult HBV for sex, age, duration of HCV infection, histological markers, presence of anti-HBc, HCV viral load, and HCV genotype. The response rate was significantly higher in patients with positive results for HBV-DNA test compared to those with negative findings (100% vs. 71.9 %, P < 0.05).
In conclusion, occult HBV was found in 36% of patients with negative results for HBsAg, but positive results for HCV. Detection of HBV-DNA in both PBMCs and plasma together in comparison with plasma alone provided more true identification of OBI.The SVR rate was significantly higher in coinfected patients than mono-infected ones.
隐匿性乙型肝炎病毒（HBV）感染（OBI）在慢性丙型肝炎病毒（HCV）感染患者中屡有报道。提示OBI与HCV感染患者肝脏损伤加重、肝硬化、肝细胞癌以及对干扰素治疗反应降低之间存在关联。
本研究旨在确定隐匿性HBV的流行率，并评估其对慢性HCV患者的临床影响。
进行了一项队列研究，纳入50例HCV检测结果为阳性且HBsAg检测结果为阴性的患者。患者分为两组：一组HCV和隐匿性HBV检测结果均为阳性（n = 18），另一组HCV检测结果为阳性但隐匿性HBV检测结果为阴性（n = 32）。所有患者均接受聚乙二醇干扰素α-2a和利巴韦林治疗。对这些患者随访HCV RNA的存在情况。
采用巢式PCR在20%的血浆和32.6%的外周血单个核细胞（PBMC）区室中检测到HBV-DNA。隐匿性HBV阳性和阴性患者在性别、年龄、HCV感染持续时间、组织学指标、抗-HBc存在情况、HCV病毒载量和HCV基因型方面未观察到显著差异。HBV-DNA检测结果为阳性的患者的应答率显著高于检测结果为阴性的患者（100%对71.9%，P < 0.05）。
总之，在HBsAg检测结果为阴性但HCV检测结果为阳性的患者中，36%发现存在隐匿性HBV。与仅检测血浆相比，同时检测PBMC和血浆中的HBV-DNA能更准确地识别OBI。合并感染患者的持续病毒学应答率显著高于单一感染患者。
