gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2021-31-1-7-19gastro-j-514Research ArticleОБЗОРЫREVIEWSПеренесенный гепатит В: разрешившаяся проблема или мнимое благополучие?Resolved Hepatitis B: Achieved or Imaginary Wellbeing?https://orcid.org/0000-0002-5917-203XБацкихС. Н.BatskikhS. N.

Бацких Сергей Николаевич — кандидат медицинских наук, старший научный сотрудник отдела гепатологии МКНЦ им. А.С. Логинова

Sergey N. Batskikh — Cand. Sci. (Med.), Senior Researcher, Department of Hepatology, Loginov Moscow Clinical Scientific Center.

111123, Moscow, Entuziastov highway, 86.

zdoc@mail.ruМосковский клинический научно-практический центр имени А.С. Логинова Департамента здравоохранения города МосквыРоссияLoginov Moscow Clinical Scientific CenterRussian Federation202115012021311719Copyright © Бацких С.Н., 20212021Бацких С.Н.Batskikh S.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/514Цель обзора

Цель обзора: оценить клиническое значение перенесенного вирусного гепатита В (ПГВ).

Основные положения

Основные положения. Для ПГВ характерно сохранение ДНК вируса в организме (включая внутрипеченочную cccDNA и интегрированную ДНК). Возможное сохранение персистенции вируса в гепатоцитах пациента, перенесшего гепатит В, создает потенциальную угрозу передачи инфекта через гемотрансфузии, трансплантацию органов и гемодиализ. Скрытое течение вирусной инфекции у лиц с ПГВ может служить основой для ее реактивации на фоне иммуносупрессивной или химиотерапии. При хронических заболеваниях печени различной этиологии наличие ПГВ у пациента в анамнезе значительно повышает риск цирроза и рака печени. Имеющиеся данные об ассоциации ПГВ с аутоиммунными заболеваниями печени и внепеченочным раком органов желудочно-кишечного тракта нуждаются в тщательном изучении для подтверждения возможной роли вируса гепатита В в генезе этих заболеваний.

Заключение

Заключение. Несмотря на наблюдающееся при ПГВ исчезновение клинических и лабораторных признаков острого или хронического заболевания, клиренс HBsAg и снижение до неопределяемого уровня ДНК ВГВ в крови, это не всегда означает окончательное разрешение проблемы. Идентификация ПГВ у условно здоровых лиц и пациентов с различными хроническими заболеваниями способствует более точному определению глобального прогноза, позволяет уменьшить риск передачи вируса и предотвратить реактивацию инфекции.

Aim

Aim. Assessment of the clinical impact of previous hepatitis B infection (PHB).

Key points

Key points. PHB is characterized by the presence of viral DNA in the organism (including intrahepatic cccDNA and integrated DNA). Possible virus persistence in the PHB patient's hepatocytes potentiates the agent transmission risk via haemotransfusion, organ transplantation and haemodialysis. Occult HBV infection in PHB individuals can reactivate at background immunosuppressive or chemotherapies. PHB with chronic liver diseases of various aetiology significantly rises the risk of cirrhosis and hepatic cancer. The PHB association with autoimmune liver diseases and extrahepatic gastrointestinal cancer needs a careful research to confirm the possible involvement of hepatitis B virus in morbid genesis.

Conclusion

Conclusion. No clinical signs of acute or chronic disease, HBsAg clearance and negative viral DNA load in blood of PHB individuals do not necessarily imply a complete disease eradication.

PHB elicitation improves accuracy of the overall prognosis, reduces the virus transmission risk and prevents the reactivation of HBV infection.

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