Tổng quan về nhiễm siêu vi viêm gan B tiềm ẩn=An overview of occult hepatitis B virus infection

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Tác giả: Đình Vĩnh Phúc Lê, Thanh Hải Phan

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.53-59

Bộ sưu tập: Báo, Tạp chí

ID: 243683

Thêm vào giỏ

Nhiễm siêu vi viêm gan B tiềm ẩn (occult hepatitis B infection: OBI) là tình trạng vẫn hiện diện HBV DNA (hepatitis B virus DNA) có khả năng sao chép trong tế bào gan bị nhiễm, có thể có hoặc không có HBV DNA trong huyết thanh ở người có xét nghiệm kháng nguyên bề mặt siêu vi B (hepatitis B surface antigen: HBsAg) âm tính. Trong hình thái viêm gan đặc biệt này, ccc DNA (covalently closed circular DNA) tồn tại ở trạng thái với khả năng sao chép thấp do liên quan cơ chế kiểm soát miễn dịch của người bệnh và yếu tố biểu hiện gen của virus. OBI phân bố trên toàn thế giới với tỉ lệ bệnh khác nhau ở các nhóm dân số khác nhau phụ thuộc vào khu vực địa lý, yếu tố nguy cơ lây truyền và xét nghiêm HBsAg, HBV DNA được sử dụng. OBI có một số tác động trên lâm sàng bao gồm: a) lây truyền qua truyền máu, ghép gan gây ra bệnh cảnh viêm gan siêu vi B kinh điển
b) gây viêm gan tái hoạt ở người sử dụng thuốc ức chế miễn dịch đưa đến viêm gan bùng phát
c) tiến triển mạn tính đến xơ gan
d) tiến triển ung thư biểu mô tế bào gan (hepatocellular carcinoma: HCC).Occult hepatitis B virus (HBV) infection (OBI) refers to a condition in which replicationcompetent viral DNA is present in the liver (with detectable or undetectable HBV DNA in the serum) of individuals testing negative for the HBV surface antigen (HBsAg). In this peculiar phase of HBV infection, the covalently closed circular DNA (cccDNA) is in a low state of replication. Many advances have been made in clarifying the mechanisms involved in such a suppression of viral activity, which seems to be mainly related to the host’s immune control and epigenetic factors. OBI is diffused worldwide, but its prevalence is highly variable among patient populations. This depends on different geographic areas, risk factors for parenteral infections, and assays used for HBsAg and HBV DNA detection. OBI has an impact in several clinical contexts: it can be transmitted, causing a classic form of hepatitis B, through blood transfusion or liver transplantation
it may reactivate in the case of immunosuppression, leading to the possible development of even fulminant hepatitis
it may accelerate the progression of chronic liver disease due to different causes toward cirrhosis
it maintains the pro-oncogenic properties of the “overt” infection, favoring the development of hepatocellular carcinoma.

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