Secretaria de Estado da Saúde -SES/Superintendência de Vigilância em Saúde-SUVISA/GO, Gerência de Vigilância Epidemiológica de Doenças Transmissíveis-GVEDT/Coordenação de Análises e Pesquisas-CAP, Goiânia, Brazil.
Laboratory of Human Virology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil.
Mol Biol Rep. 2023 Aug;50(8):6435-6443. doi: 10.1007/s11033-023-08546-7. Epub 2023 Jun 16.
Acute or chronic HBV infection in an individual can be laboratory characterized according to the serological profile of the viral markers in the bloodstream, and the dynamics monitoring of these markers is necessary to assess the disorder course and the infection outcome. However, under certain circumstances unusual or atypical serological profiles may be observed in both acute and chronic HBV infection. They are considered as such because they do not properly characterize the form or infection clinical phase or because they seem inconsistent, considering the viral markers dynamics in both clinical contexts. This manuscript comprises the analysis of an unusual serological profile in HBV infection.
This clinical-laboratory study, had as reference a patient who presented clinical profile suggestive of acute HBV infection after recent exposure, whose laboratory data were initially compatible with this clinical presentation. However, the serological profile analysis and its monitoring demonstrated unusual pattern of viral markers expression, which has been observed in several clinical contexts, and is often associated a number of agent- or host-related factors.
The serological profile analyzed here, associated with the biochemical markers serum levels found, is indicative of active chronic infection, consequence of viral reactivation. This finding suggests that in the event of unusual serological profiles in HBV infection, if the influence of agent- or host-related factors is not properly considered and neither the viral markers dynamics properly analyzed, there may be mistake in the infection clinical diagnosis, especially when the patient's clinical and epidemiological history is unknown.
个体中急性或慢性 HBV 感染可以根据血液中病毒标志物的血清学特征进行实验室鉴定，对这些标志物的动态监测对于评估疾病过程和感染结局是必要的。然而，在某些情况下，急性和慢性 HBV 感染都可能观察到不寻常或非典型的血清学特征。之所以将其视为非典型，是因为它们不能正确描述形式或感染的临床阶段，或者因为考虑到两种临床情况下的病毒标志物动态，它们似乎不一致。本文分析了 HBV 感染中一种不寻常的血清学特征。
这项临床实验室研究以一名近期暴露后出现急性 HBV 感染临床特征的患者为参考，其实验室数据最初与该临床表现相符。然而，血清学特征分析及其监测显示出病毒标志物表达的不寻常模式，这种模式在多种临床情况下都有观察到，并且通常与多种与病原体或宿主相关的因素有关。
这里分析的血清学特征，与发现的血清生化标志物水平相关，提示为病毒再激活引起的活动性慢性感染。这一发现表明，在 HBV 感染中出现不寻常的血清学特征时，如果不能正确考虑病原体或宿主相关因素的影响，也不能正确分析病毒标志物的动态，可能会导致感染的临床诊断错误，尤其是当患者的临床和流行病学病史未知时。
