Huang X, Hollinger F B
Department of Blood Transfusion, The General Hospital of Jinan Military Command, Jinan, China.
J Viral Hepat. 2014 Mar;21(3):153-62. doi: 10.1111/jvh.12222.
Occult hepatitis B (OHB) infection has been reported to play an important role in the development of hepatocellular carcinoma (HCC). In this systematic review, a significantly higher prevalence of OHB was observed in patients with HCC in the presence or absence of HCV infection when compared with control populations without HCC. Correspondingly, among adequately designed prospective studies, the cumulative probability of developing HCC was significantly greater among patients with OHB than among HBV DNA-negative patients in the presence or absence of HCV infection. Study design, inclusion criteria, treatment options, methodology and potential confounding variables were evaluated, and immunopathogenic mechanisms that could be involved in OHB as a risk factor in HCC were reviewed. From this analysis, we conclude that although OHB is an independent risk factor in HCC development in anti-HCV-negative patients, a synergistic or additive role in the occurrence of HCC in HCV-coinfected patients is more problematic due to the HCC risk attributable to HCV alone, especially in patients with advanced fibrosis and cirrhosis.
据报道，隐匿性乙型肝炎（OHB）感染在肝细胞癌（HCC）的发生发展中起重要作用。在这项系统评价中，与无HCC的对照人群相比，无论是否存在丙型肝炎病毒（HCV）感染，HCC患者中OHB的患病率均显著更高。相应地，在设计充分的前瞻性研究中，无论是否存在HCV感染，OHB患者发生HCC的累积概率均显著高于HBV DNA阴性患者。对研究设计、纳入标准、治疗选择、方法学及潜在混杂变量进行了评估，并综述了OHB作为HCC危险因素可能涉及的免疫致病机制。通过该分析，我们得出结论，尽管OHB是抗HCV阴性患者发生HCC的独立危险因素，但在HCV合并感染患者中，由于仅HCV就可导致HCC风险，尤其是在晚期纤维化和肝硬化患者中，OHB在HCC发生中的协同或叠加作用更成问题。
