Jang Jae Young, Park Eui Ju
Institution for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2013 Sep;62(3):154-9. doi: 10.4166/kjg.2013.62.3.154.
Occult HBV infection is defined as the presence of HBV DNA in the liver (with or without detectable or undetectable HBV DNA in the serum) of individuals testing negative for HBsAg. Studies on occult HBV infection in hepatitis C patients have reported highly variable prevalence, because the prevalence of occult HBV infection varies depending on the hepatitis B risk factors and methodological approaches. The most reliable diagnostic approach for detecting occult HBV detection is through examination of liver DNA extracts. HCV has been suspected to strongly suppress HBV replication up to the point where it may be directly responsible for occult HBV infection development. However, more data are needed to arrive at a definitive conclusion regarding the role of HCV in inducing occult HBV infection. Occult HBV infection in chronic hepatitis C patients is a complex biological entity with possible relevant clinical implications. Influence of occult HBV infection on the clinical outcomes of chronic hepatitis C may be considered negative. However, recent studies have shown that occult HBV infection could be associated with the development of hepatocellular carcinoma and contribute to the worsening of the course of chronic liver disease over time in chronic hepatitis C patients. Nevertheless, the possible role of occult HBV infection in chronic hepatitis C is still unresolved and no firm conclusion has been made up until now. It still remains unclear how occult HBV infection affects the treatment of chronic hepatitis C. Therefore, in order to resolve current controversies and understand the pathogenic role and clinical impacts of occult HBV infection in chronic hepatitis C patients, well-designed clinical studies are needed.
隐匿性乙型肝炎病毒感染的定义为，乙肝表面抗原检测呈阴性的个体肝脏中存在乙肝病毒DNA（血清中乙肝病毒DNA可检测到或检测不到）。关于丙型肝炎患者隐匿性乙型肝炎病毒感染的研究报告显示，其患病率差异很大，因为隐匿性乙型肝炎病毒感染的患病率因乙肝风险因素和方法学的不同而有所差异。检测隐匿性乙型肝炎病毒最可靠的诊断方法是检测肝脏DNA提取物。丙型肝炎病毒被怀疑会强烈抑制乙肝病毒复制，甚至可能直接导致隐匿性乙型肝炎病毒感染的发生。然而，关于丙型肝炎病毒在隐匿性乙型肝炎病毒感染中的作用，还需要更多数据才能得出明确结论。慢性丙型肝炎患者中的隐匿性乙型肝炎病毒感染是一个复杂的生物学实体，可能具有相关的临床意义。隐匿性乙型肝炎病毒感染对慢性丙型肝炎临床结局的影响可能被认为是负面的。然而，最近的研究表明，隐匿性乙型肝炎病毒感染可能与肝细胞癌的发生有关，并随着时间的推移导致慢性丙型肝炎患者慢性肝病病情恶化。尽管如此，隐匿性乙型肝炎病毒感染在慢性丙型肝炎中的可能作用仍未解决，迄今为止尚未得出确凿结论。隐匿性乙型肝炎病毒感染如何影响慢性丙型肝炎的治疗仍不清楚。因此，为了解决当前的争议，了解隐匿性乙型肝炎病毒感染在慢性丙型肝炎患者中的致病作用和临床影响，需要精心设计的临床研究。
