Occult hepatitis B virus infection
Abstract
The aim. To present the review of literature data for state-of the art of occult (latent) hepatitis B virus (HBV) infection in the modern world.
Recent literature data. A phenomenon of latent infection HBV is related mainly to intrahepatic persistence of viral cccDNA and severe suppression of viral replication and expression of viral antigens. Taking into account very low level of DNA HBV its detection requires very sensitive serological and specific molecular biology methods. Inhibition of HBV replication is reversible and latent infection can turn into acute which, as a rule, progress very severely. At infestation by hepatitis B virus from subjects with latent course of HBV-infection (at hemotransfusion or transplantation of organs and tissues) acute hepatitis can develop as well. Due to persistence of virus moderate progressing necroinflammatory reaction in liver tissue is observed, which for a long time can (even at the absence of other causes) result in liver cirrhosis. Besides this, the latent HBV-infection has oncogenic properties, that are characteristic for classical, «manifestative» infection, and thus it is an important risk factor for hepatocellular carcinoma development.
Conclusion. Studying of the issues related to latent course of hepatitis B virus infection, has the important value for definition of management of such patients. At the moment there are no clear references concerning terms of follow-up, and no fixed criteria for onset of antiviral therapy, its validity, duration and evaluation of results.
About the Authors
V. T. IvashkinRussian Federation
Ye. N. German
Russian Federation
M. V. Maevskaya
Russian Federation
References
1. Абдурахманов Д.Т. Латентная HBV-инфекция в патогенезе хронических заболеваний печени // Рос. журн. гастроентерол. гепатол. колопроктол. – 2002. – № 6. – С. 31–37.
2. Апросина З.Г., Серов В.В. Патогенез хронического гепатита В // Арх. патол. – 2001. – № 2. – С. 58–62.
3. Болезни печени и желчевыводящих путей: Руководство для врачей / Под ред. В.Т. Ивашкина. – 2-е изд., испр. и доп. – М.: Изд. дом «М-Вести», 2005. – С. 103.
4. Маевская М.В. Лечение хронических вирусных гепатитов // Лечащий врач. – 2005. – № 2. – С. 31–37.
5. Назаренко С.А. Эволюционная биология: Материалы II Междунар. конф. «Проблема вида и видообразование». – Томск: Изд. Томского гос. ун-та, 2002. – Т. 2. – С. 82–93.
6. Berasain C, Betes M, Panizo A, et al. Pathological and virological findings in patients with persistent hypertransaminasaemia of unknown aetiology. Gut 2000; 47:429-35.
7. Besisik F, Karaca C, Akyuz F, et al. Occult HBV infection and YMDD variants in hemodialysis patients with chronic HCV infection. J Hepatol 2003; 38:506-10.
8. Brechot C. Pathogenesis of hepatitis B virus-related hepatocelular carcinoma: old and new paradigms. Gastroenterology 2004; 127:56-61.
9. Cacciola I, Pollicino T, Squadrito G, et al. Occult hepatitis B virus infection in patients with chronic hepatitis C liver disease. N Engl J Med 1999; 341:22-6.
10. Chemin I, Trepo C. Clinical impact of occult HBV infections. J Clin Virol 2005; 34:15-21.
11. Chemin I, Zoulim F, Merle P, et al. High incidence of hepatitis B infections among chronic hepatitis cases of unknown aetiology. J Hepatol 2001; 34:447-54.
12. Chen SY, Kao CF, Chen CM, et al. Mechanisms for inhibition of hepatitis B virus gene expression and replication by hepatitis C virus core protein. J Biol Chem 2003; 278:591-607.
13. Chen YC, Sheen IS, Chu CM, Liaw YF. Prognosis following spontaneous HBsAg seroclearance in chronic hepatitis B patients with or without concurrent infection. Gastroenterology 2002; 123:1084-9.
14. Chevrier MC, St-Louis M, Perreault J, et al. Detection and characterization of hepatitis B virus of anti-hepatitis B core antigen-reactive blood donors in Quebec with an in-house nucleic acid testing assay. Transfusion 2007 Oct; 47(10):1794-802.
15. Dhedin N, Douvin C, Kuentz M, et al. Reverse seroconversion of hepatitis B after allogeneic bone marrow transplantation: a retrospective study of 37 patients with pretransplant anti-HBs and anti-HBc. Transplantation 1998; 66:616-9.
16. Dickson RC, Everhart JE, Lake JR, et al. Transmission of hepatitis B by transplantation of livers from donors positive for antibody to hepatitis B core antigen. Gastroenterology 1997; 113:1668-74.
17. Donato F, Gelatti U, Limina RM, Fattovich G. Souther Europe as an example of interaction between various enviror mental factors: a systematic review of the epidemiologic evidence. Oncogene 2006; 25:3756-70.
18. Fabrizi F, Messa PG, Lunghi G, et al. Occult hepatitis B virus infection in dialysis patients: a multicentre survey. Aliment Pharmacol Ther 2005; 21:1341-7.
19. Ganem D, Prince AM. Hepatitis B virus infection - natural history and clinical consequences. N Engl J Med 2004; 350:1118-29.
20. Guidotti LG, Chisari FV. Noncytolytic control of viral infections by the innate and adaptive immune response. Annu Rev Immunol 2001; 19:65-91.
21. Guidotti LG, Rochford R, Chung J, et al. Viral clearance without destruction of infected cells during acute HBV infection. Science 1999; 284:825-9.
22. Hass M, Hannoun C, Kalinina T, et al. Functional analysis of hepatitis B virus reactivating in hepatitis B surface antigen-negative individuals. Hepatology (Baltimore, MD) 2005; 42:93-103.
23. Hilleman MR. Overview of the pathogenesis, prophylaxis and therapeusis of viral hepatitis B, with focus on reduction to practical applications. Vaccine 2001; 19:1837-48.
24. Hou J, Karayiannis P, Walters J, et al. A unique insertion in the S gene of surface antigen-negative hepatitis B virus Chinese carriers. Hepatology (Baltimore, MD) 1995; 21:273-8.
25. Hussain M, Soldevila-Pico C, Emre S, et al.; NIH HBV-OLT Study Group. Presence of intrahepatic (total and ccc) HBV DNA is not predictive of HBV recurrence after liver transplantation. Liver Transpl. 2007 Aug; 13(8):1137-44.
26. Iannitto E, Minardi V, Calvaruso G, et al. Hepatitis B virus reactivation and ale-mtuzumab therapy. Eur J Haematol 2005; 74:254-8.
27. Jeantet D, Chemin I, Mandrand B, et al. Cloning and expression of surface antigens from occult chronic hepatitis B virus infections and their recognition by commercial detection assays. J Med Virol 2004; 73:508-15.
28. Kawatani T, Suou T, Tajima F, et al. Incidence of hepatitis virus infection and severe liver dysfunction in patients receiving chemotherapy for hematologic malignancies. Eur J Haematol 2001; 67:45-50.
29. Lok ASF, Liang RHS, Chiu EKW, et al. Reactivation of hepatitis B virus replication in patients receiving cytotoxic therapy. Gastroenterolgy 1991; 100:182-8.
30. Marcellin P, Giostra E, Martinot-Peignoux M, et al. Redevelopment of hepatitis B surface antigen after renal transplantation. Gastroenterology 1991; 100:1432-4.
31. Marion PI. In Ground squirrel hepatitis virus. In: McLachlan A, editor. Molecular biology of hepatitis B virus. Boca Raton, Florida: CRC Press; 1991. p. 39-51.
32. Marusawa H, Uemoto S, Hijikata M, et al. Latent hepatitis B virus infection in healthy individuals with antibodies to hepatitis B core antigen. Hepatology (Baltimore, MD) 2000; 31:488-95.
33. Mc Clary H, Koch R, Chisari FV, Guidotti LG. Inhibition of hepatitis B virus replication during schistosoma mansoni infection in transgenic mice. J Exp Med 2000; 192:289-94.
34. Michalak TI, Mulrooney PM, Coffin CS. Low doses of hepadnavirus induce infection of the lymphatic system that does not engage the liver. J Virol 2004; 78:1730-8.
35. Michalak TI, Pardoe IU, Coffin CS, et al. Occult lifelong persistence of infectious hepadnavirus and residual liver inflammation in woodchucks convalescent from acute viral hepatitis. Hepatology (Baltimore, MD) 1999; 29:928-38.
36. Minuk GY, Sun DF, Greenberg R, et al. Occult hepatitis B virus infection in a North American adult hemodialysis patient population. Hepatology (Baltimore, MD) 2004; 40:1072-7.
37. Patrick Yachimski, Raymond T. Chung. Hepatitis B virus infection in liver transplant candidates and recipients // Medscape General Medicine. 2005; 7(2):20.
38. Pollicino T, Belloni L, Raffa G, et al. Hepatitis B virus replication is regulated by the acetylation status of hepatitis B virus cccDNA-bound H3 and H4 histones. Gastroenterology 2006; 130:823-37.
39. Raimondo G. Occult hepatitis B virus infection. J Hepatol (46) 2007; 160-70.
40. Regan FA, Hewitt P, Barbara JA, Contreras M. Prospective investigation of transfusion transmitted infection in recipients of over 20 000 units of blood. TTI Study Group. BMJ (Clinical research ed) 2000; 320:403-6.
41. Rehermann B, Ferrari C, Pasquinelli C, Chisari FV. The hepatitis B virus persists for decades after patients’ recovery from acute viral hepatitis despite active maintenance of a cytotoxic T-lymphocyte response. Nat Med 1996; 10:1104-8.
42. Sagnelli E, Coppola N, Scolastico C, et al. Isolated anti-HBc in chronic hepatitis C predicts a poor response to interferon treatment. J Med Virol 2001; 65:681-7.
43. Samuel D, Forns X, Berenguer M, et al. Report of the monothematic EASL conference on liver transplantation for viral hepatitis (Paris, France, January 12-14, 2006). J Hepatol 2006; 45:127-43.
44. Schuttler CG, Fiedler N, Schmidt K, et al. Suppression of hepatitis B virus enhancer 1 and 2 by hepatitis C virus core protein. J Hepatol 2002; 37:855-62.
45. Sera T, Hiasa Y, Michitaka K, et al. Anti-HBs-positive liver failure due to hepatitis B virus reactivation induced by rituximab. Internal Med (Tokyo, Japan) 2006; 45:721-4.
46. Torbenson M, Kannangai R, Astemborski J, et al. High prevalence of occult hepatitis B in Baltimore injection drug users. Hepatology (Baltimore, MD) 2004; 39:51-7.
47. Torbenson M, Thomas DL. Occult hepatitis B. Lancet Infect Dis 2002; 2:479-86.
48. Toyoda H, Hayashi K, Murakami Y, et al. Prevalence and clinical implications of occult hepatitis B viral infection in hemophilia patients in Japan. J Med Virol 2004; 73:195-9.
49. Wursthorn K, Lutgehetmann M, Dandri M, et al. Peginterferon alpha-2b plus adefovir induce strong cccDNA decline and HBsAg reduction in patients with chronic hepatitis B. Hepatology (Baltimore, MD) 2006; 44:675-84.
50. Yoshiba M, Sekiyama K, Sugata F, et al. Post-transfusion fulminant hepatitis B after screening for hepatitis B virus core antibody. Lancet 1992; 339:253-4.
51. Yu MC, Yuan JM, Ross RK, Govindarajan S. Presence of antibodies to the hepatitis B surface antigen is associated with an excess risk for hepatocellular carcinoma among non-Asians in Los Angeles County, California. Hepatology (Baltimore, MD) 1997; 25:226-8.
52. Yuki N, Nagaoka T, Yamashiro M, et al. Long-term histologic and virologic outcomes of acute self-limited hepatitis B. Hepatology (Baltimore, MD) 2003; 37:1172-9.
53. Zoulim F. New insight on hepatitis B virus persistence from the study of intrahepatic viral cccDNA. J Hepatol 2005; 42:302-8.
Review
For citations:
Ivashkin V.T., German Ye.N., Maevskaya M.V. Occult hepatitis B virus infection. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2008;18(2):4-11. (In Russ.)
Views:
3
Email this article 
