Baghbanian Mahmud, Halvani Mehdi, Roghani Hassan Salman, Lotfi Mohammad Hassan, Yazdi Mohammad Frahat, Vahedian-Ardakani Hassan-Ali
Department of Gastroenterology, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Department of Internal Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Arq Gastroenterol. 2016 Jul-Sep;53(3):175-9. doi: 10.1590/S0004-28032016000300010.
Occult hepatitis B infection is characterized by negative hepatitis B surface antigen (HBsAg) and also detectable hepatitis B virus (HBV) -DNA, with or without hepatitis B core antibody (anti-HBc). HBV reactivation in individuals under immunosuppressive therapy is critical, occurring in occult HBV.
In this study, we aimed to determine the prevalence of occult HBV infection among hepatitis B surface antigen negative in cancer patients before receiving chemotherapy.
Sera from 204 cancer patients who were negative for HBsAg, were tested for anti-HBc antibodies. The samples that were negative for HBsAg but positive for anti-HBc also examined for HBV-DNA by polymerase chain reaction (PCR).
Of the 204 HBsAg negative blood samples, 11 (5.4%) samples were positive for anti-HBc antibodies. HBV-DNA was detected in 9/11 (81%) of anti-HBc positive samples. Occult HBV infection in hematological cancers was more than solid cancers, 4.8% and 4.3% respectively. There was no significant difference in HBc antibody positivity based on vaccination, previous blood transfusions, history of familial hepatitis or biochemical parameters (ALT, AST, total and direct bilirubin levels) (P>0.05).
Screening of occult HBV infection by HBsAg, HBV DNA and anti HB core antibody should be suggested as a routine investigation in cancer patients before receiving chemotherapy.
隐匿性乙型肝炎感染的特征是乙型肝炎表面抗原（HBsAg）呈阴性，但仍可检测到乙型肝炎病毒（HBV）-DNA，无论有无乙型肝炎核心抗体（抗-HBc）。免疫抑制治疗个体中的HBV再激活至关重要，在隐匿性HBV感染中会发生。
在本研究中，我们旨在确定癌症患者在接受化疗前乙型肝炎表面抗原阴性者中隐匿性HBV感染的患病率。
对204例HBsAg阴性的癌症患者血清进行抗-HBc抗体检测。对HBsAg阴性但抗-HBc阳性的样本也通过聚合酶链反应（PCR）检测HBV-DNA。
在204份HBsAg阴性血样中，11份（5.4%）样本抗-HBc抗体呈阳性。在11份抗-HBc阳性样本中的9份（81%）检测到HBV-DNA。血液系统癌症中的隐匿性HBV感染多于实体癌，分别为4.8%和4.3%。基于疫苗接种、既往输血史、家族性肝炎病史或生化参数（ALT、AST、总胆红素和直接胆红素水平），HBc抗体阳性率无显著差异（P>0.05）。
建议在癌症患者接受化疗前，将检测HBsAg、HBV DNA和抗HB核心抗体作为隐匿性HBV感染的常规筛查项目。
