СКРЫТЫЙ ГЕПАТИТ В: КЛИНИЧЕСКОЕ ЗНАЧЕНИЕ И ПРОБЛЕМЫ ДИАГНОСТИКИ
https://doi.org/10.20514/2226-6704-2012-0-4-39-45
Abstract
In this report we present current data on prevalence, clinical significance and methods of diagnostics of occult hepatitis B. Mechanisms of occult hepatitis B formation are reviewed, among which the most important is co-infection with other hepatotropic viruses. Diagnostic significance of anti-HBcAg antibodies is shown. An algorithm of occult hepatitis B detection developed by the authors involves two stages: detection of viral markers in serum and liver tissue. Attention is drawn to the role of morphologic methods including histochemistry, immunohistochemistry and electron microscopy in verification of HBVinfection and direct visualization of virions in cytoplasm of hepatocytes.
About the Authors
И. А. МорозовRussian Federation
отдел вирусных гепатитов, Москва
Л. Ю. Ильченко
Russian Federation
отдел вирусных гепатитов, Москва
И. Г. Федоров
Russian Federation
кафедра госпитальной терапии № 2 лечебного факультета, Москва;
отделение гастроэнтерологии и гепатологии, Москва
И. В. Гордейчук
Russian Federation
отдел вирусных гепатитов, Москва
И. Н. Гордейчук
Russian Federation
кафедра инфекционных болезней
А. К. Княженцева
Russian Federation
отдел вирусных гепатитов, Москва
Е. А. Зверкова
Russian Federation
отдел вирусных гепатитов, Москва
М. И. Михайлов
Russian Federation
отдел вирусных гепатитов, Москва
Г. И. Сторожаков
Russian Federation
кафедра госпитальной терапии № 2 лечебного факультета, Москва
References
1. Вирусные гепатиты в Российской Федерации 2009. Аналитический обзор / Под ред. Г.Г. Онищенко, А.Б. Жебруна. СПб.: НИЭМ им. Пастера, 2009. C. 17–41.
2. Гордейчук И.В. Выявление и клинико-морфологическая характеристика скрытой ВГВ-инфекции среди HBsAg-негативных пациентов с хроническими заболеваниями печени // ДЖИП. 2010. № 17. С. 42–49.
3. Морозов И.А., Ильченко Л.Ю., Кюрегян К.К. и др. Латентная HBV-инфекция и алгоритм ее выявления у пациентов с хроническими заболеваниями печени // В мире вирусных гепатитов. 2011. № 1. С. 19–26.
4. Bellecave P., Gouttenoire J., Gajer M. et al. Hepatitis B and C virus coinfection: a novel model system reveals the absence of direct viral interference // Hepatol. 2009. Vol. 50. P. 46–55.
5. Cacciola I., Pollicino T., Squadrito G. et al. Occult hepatitis В virus infection in patients with chronic hepatitis С liver disease // NEJM. 1999. Vol. 341. P. 22–26.
6. Carman W.F. The clinical significance of surface antigen variants of hepatitis B virus // J. Viral. Hepat. 1997. Vol. 4. P. 11–20.
7. Castillo I., Rodriguez-Ilcigo E., Lypez-Alcorocho J. et al. Comparative study on the clinical and virological characteristics among patients with single occult hepatitis В virus (HBV), single occult hepatitis С virus (HCV) and occult HBV and HCV dual infection // J. Med. Virol. 2007. Vol. 3. P. 236–241.
8. Chu C.J., Lee S.D. Hepatitis B virus/hepatitis C virus coinfection: epidemiology, clinical features, viral interactions and treatment // J. Gastroenterol. Hepatol. 2008. Vol. 23. P. 512–520.
9. Coffin C.S., Michalak T.I. Persistence of infectious hepadnavirus in the offspring of woodchuck mothers recovered from viral hepatitis // J. Clin. Invest. 1999. Vol. 104. P. 203–212.
10. Coffin C.S., Pham T.N.Q., Mulrooney P.M. et al. Persistence of isolated antibodies to woodchuck hepatitis virus core antigen is indicative of occult infection // Hepatol. 2004. Vol. 40. P. 1053–1061.
11. Hollinger F.B. Hepatitis B virus infection and transfusion medicine: science and the occult // Transfusion. 2008. Vol. 48. P. 1001–1026.
12. Hollinger F.B., Sood G. Occult hepatitis B virus infection: a covert operation // J. Viral Hepat. 2010. Vol. 17. P. 1–15.
13. Hu K.Q. Occult hepatitis .B virus infection and its clinical implications // J. Viral Hepat. 2002. Vol. 9. P. 243–257.
14. Jeantet D., Chemin I., Mandrand B. et al. Cloning and expression of surface antigens from occult chronic hepatitis В virus infections and their recognition by commercial detection assays // J. Med. Virol. 2004. Vol. 73. P. 508–515.
15. Madejon A., Manzano M.L., Arocena C. et al. Effects of delayed freezing of liver biopsies on the detection of hepatitis C virus RNA strands // J. Hepatol. 2000. Vol. 32. P. 1019–1025.
16. Marusawa H., Uemoto S., Hijikata M. et al. Latent hepatitis B virus infection in healthy individuals with antibodies to hepatitis B core antigen // Hepatol. 2000. Vol. 31. P. 488–495.
17. McMahon B.J., Holck P., Bulkow L., Snowball M. Serologic and clinical outcomes of 1536 Alaska natives chronically infected with hepatitis B virus // Ann. Intern. Med. 2001. Vol. 135. P. 759–768.
18. Michalak T.I., Pasquinelli C., Guilhot S., Chisari F.V. Hepatitis B virus persistence after recovery from acute viral hepatitis // J. Clin. Invest. 1994. Vol. 93. P. 230–239.
19. Mimms L.T., Mosley J.W., Hollinger F.B. et al. Effect of concurrent acute infection with hepatitis C virus on acute hepatitis B virus infection // BMJ. 1993. Vol. 307. P. 1095–1097.
20. Ninomiya M., Takahashi M., Nishizava T. et al. Development of PCR assays with nested primers specific for differential detection of the three human anelloviruses and early acquisition of dual or triple infection during infancy // J. Clin. Microbiol. 2008. Vol. 46. P. 507–514.
21. Pasquinelli C., Shoenberger J.M., Chung J. et al. Hepatitis C virus core and E2 protein expression in transgenic mice // Hepatol. 1997. Vol. 25. P. 719–727.
22. Raimondo G., Navarra G., Mondello S. et al. Occult hepatitis B virus in liver tissue of individuals without hepatic disease // J. Hepatol. 2008. Vol. 48. P. 743–746.
23. Raimondo G., Allain J.P., Brunetto M.R. Statements from the Taormina expert meeting on occult hepatitis B virus infection // J. Hepatol. 2008. Vol. 49. P. 652–657.
24. Torbenson M., Thomas D.L. Occult hepatitis B // Lancet Infect. Dis. 2002. Vol. 2. P. 479–486.
25. Weinberger K.M., Bauer T., Bohm S., Jilg W.G. High genetic variability of the group-specific a-determinant of hepatitis B virus surface antigen (HBsAg) and the corresponding fragment of the viral polymerase in chronic virus carriers lacking detectable HBsAg in serum // J. Gen. Virol. 2000. Vol. 81. P. 1165–1174.
26. Zerbini A., Pilli M., Boni C. et al. The characteristics of the cellmediated immune response identify different profiles of occult hepatitis B virus infection // Gastroenterol. 2008. Vol. 134. P. 1470–1481.
Review
For citations:
Морозов И.А., Ильченко Л.Ю., Федоров И.Г., Гордейчук И.В., Гордейчук И.Н., Княженцева А.К., Зверкова Е.А., Михайлов М.И., Сторожаков Г.И. СКРЫТЫЙ ГЕПАТИТ В: КЛИНИЧЕСКОЕ ЗНАЧЕНИЕ И ПРОБЛЕМЫ ДИАГНОСТИКИ. The Russian Archives of Internal Medicine. 2012;(4):39-45. (In Russ.) https://doi.org/10.20514/2226-6704-2012-0-4-39-45