gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2018-28-5-126-133gastro-j-269Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL CASESЗатяжная НВsAg-емия у пациента с острым гепатитом ВProtracted HBsAg-aemia in a Patient with Acute Hepatitis BДудинаК. Р.DudinaK. R.

доктор медицинских наук,  доцент кафедры инфекционных болезней и эпидемиологии,  ФГБОУ ВПО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Министерства Здравоохранения Российской Федерации.  

г. Москва, Волоколамское шоссе, д. 63.

Dr. Sci. (Med.), Ass. Prof., Department  of  Infectious  Diseases  and  Epidemiology,  Evdokimov  Moscow State University of Medicine and Dentistry.

Moscow, Volokolamskoe highway, 63.

dudinakr@mail.ruЗнойкоО. О.ZnoykoO. O.

 доктор медицинских наук, профессор кафедры инфекционных болезней и эпидемиологии  ФГБОУ  ВПО  «Московский  государственный  медико-стоматологический университет им. А.И. Евдокимова» Министерства Здравоохранения Российской Федерации, кафедра  инфекционных болезней и эпидемиологии.

  г. Москва, Волоколамское шоссе, д. 63.

 Dr. Sci. (Med.), Prof., Department of  Infectious  Diseases  and  Epidemiology,  Evdokimov  Moscow  State University of Medicine and Dentistry.  

Moscow, Volokolamskoe highway, 63.

olgaznoyko@yandex.ruФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Министерства Здравоохранения Российской Федерации, кафедра инфекционных болезней и эпидемиологии.РоссияA.I. Evdokimov Moscow State University of Medicine and Dentistry, Department of Infectious Diseases and Epidemiology.Russian Federation201812112018285126133Copyright © Дудина К.Р., Знойко О.О., 20182018Дудина К.Р., Знойко О.О.Dudina K.R., Znoyko O.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/269

Цель представления клинического наблюдения: проанализировать течение заболевания у пациента с длительной персистенцией HBsAg и ДНК HBV в крови в исходе острого гепатита В и возможное формирование скрытой HBV-инфекции на фоне клинического выздоровления.

Основное содержание

Основное содержание. В течение 31 месяца проведено наблюдение больного с документированным острым гепатитом В и последующим выполнением динамической оценки вирусной кинетики, качественной и количественной оценки содержания HBsAg в крови при использовании методов с высокой аналитической чувствительностью, зафиксировавшее длительную персистенцию ДНК HBV в крови и позднюю сероконверсию HBsAg/анти-HBs.

Заключение

Заключение. Данный клинический пример демонстрирует возможность атипично длительной персистенции HBsAg в исходе острого гепатита В с последующей клинико-лабораторной картиной выздоровления и формирования латентной хронической HBV-инфекции, как пример 5-й фазы хронической HBV-инфекции — HBsAg-негативной, согласно новой классификации, отраженной в клинических рекомендациях по лечению гепатита В (EASL 2017 года). 

Aim

Aim. This clinical observation was aimed at analysing the course of the disease in a patient with a protracted persistence of HBsAg and HBV DNA in the blood in the outcome of acute hepatitis B and the possible formation of a latent HBV infection in the phase of clinical recovery.

General findings

General findings. We carried out a 31-month observation study of a patient suffering from acute hepatitis B. Subsequently, we performed a dynamic assessment of the viral kinetics and qualitative and quantitative assessment of HBsAg in the blood using highly sensitive analytical methods. These methods allowed a protracted persistence of HBV DNA in the blood and a late seroconversion of HBsAg/anti-HBs to be revealed.

Conclusion

Conclusion. The described clinical case demonstrates the possibility of an atypically protracted persistence of  HBsAg in the outcome of acute hepatitis B, which is followed by a clinical and laboratory picture of recovery and the formation of latent chronic HBV infection, as an example of the 5th phase of chronic HBV infection (HBsAg-negative), according to a new classification, reflected in the clinical guidelines for the treatment of hepatitis B (EASL 2017). 

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The authors declare that there are no conflicts of interest present.