Franzè Maria Stella, Pollicino Teresa, Raimondo Giovanni, Squadrito Giovanni
Department of Clinical and Experimental Medicine, Messina University, Messina, Italy.
Division of Medicine and Hepatology, Messina University Hospital, Messina, Italy.
Liver Int. 2022 May;42(5):963-972. doi: 10.1111/liv.15233. Epub 2022 Mar 11.
Data concerning the prevalence of hepatitis B virus (HBV) occult infection (OBI) varies greatly in the different studies according to the sensitivity and specificity of the diagnostic approaches and the HBV prevalence in the different populations examined. The clinical implications of OBI are still debated. While the impact of OBI in HBV transmission as well as in HBV reactivation under immunosuppression are well established, the role of OBI in liver disease and hepatocellular carcinoma (HCC) development are still not definitively elucidated. It has been hypothesized that OBI might contribute to worsening the liver disease course when other causes of liver damage co-exist. Furthermore, much evidence suggests a role of OBI in the hepato-carcinogenesis processes through both indirect and direct oncogenic mechanisms that might favour HCC development. Data on the OBI clinical implications mainly come from studies performed in patients with hepatitis C virus (HCV) infection. However, HCV prevalence has dramatically fallen in the past years also because of the advent of specific and highly effective direct acting antivirals, with a consequent abrupt change of the worldwide scenario of chronic liver disease. Information about OBI prevalence and possible clinical impact in non-HCV-related liver disease are fragmentary, and the objective of this review is to critically summarize the available data in this field.
关于乙型肝炎病毒（HBV）隐匿性感染（OBI）的患病率数据，在不同研究中差异很大，这取决于诊断方法的敏感性和特异性以及所检测不同人群中的HBV患病率。OBI的临床意义仍存在争议。虽然OBI在HBV传播以及免疫抑制下的HBV再激活中的影响已得到充分证实，但OBI在肝病和肝细胞癌（HCC）发生发展中的作用仍未明确阐明。据推测，当存在其他肝损伤原因时，OBI可能会促使肝病病程恶化。此外，许多证据表明OBI通过可能有利于HCC发展的间接和直接致癌机制在肝癌发生过程中发挥作用。关于OBI临床意义的数据主要来自对丙型肝炎病毒（HCV）感染患者进行的研究。然而，由于特异性和高效直接作用抗病毒药物的出现，在过去几年中HCV患病率也大幅下降，导致全球慢性肝病情况发生突然变化。关于非HCV相关肝病中OBI患病率及其可能临床影响的信息支离破碎，本综述的目的是批判性地总结该领域的现有数据。
