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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 12
Dec.  2022
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Article Contents

Occult HBV infection in autoimmune hepatitis and its influence on disease progression

DOI: 10.3969/j.issn.1001-5256.2022.12.011
Research funding:

Beijing Municipal Natural Science Foundation (7111004);

Beijing Municipal Administration of Hospitals Incubating Program (PX2019062)

More Information
  • Corresponding author: SU Jianrong, youyilab@163.com (ORCID: 0000-0002-0377-1711); YAN Huiping, yhp503@126.com (ORCID: 0000-0001-5980-7675)
  • Received Date: 2022-09-05
  • Accepted Date: 2022-10-13
  • Published Date: 2022-12-20
  •   Objective  To investigate the prevalence rate of occult HBV infection (OBI) in patients with autoimmune hepatitis (AIH) and the influence of OBI in the clinical condition and prognosis of AIH patients.  Methods  A total of 103 patients with a confirmed diagnosis of AIH who were admitted to Beijing YouAn Hospital from April 2012 to March 2019 were enrolled. Nested PCR and real-time PCR were used to confirm the diagnosis of OBI, and real-time PCR was used to measure HBV pgRNA. Clinical features, laboratory markers, and follow-up analysis of prognosis were compared between the OBI group with 24 patients and the non-OBI group with 79 patients. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves, and the Cox regression model was used to perform univariate and multivariate analyses. Hazard ratio and its 95% confidence interval were calculated.  Results  The detection rate of OBI was 23.30% (24/103) in AIH patients, with an HBV DNA viral load of < 200 IU/mL, among whom 9 patients with OBI (9/24, 37.50%) were found to have HBV pgRNA in serum. Compared with the non-OBI group, the OBI group had a significantly higher positive rate of the three antibodies anti-HBs, anti-HBc, and anti-HBe (χ2=5.906, P=0.016). The univariate analysis showed that OBI, hypoproteinemia, splenomegaly, and ascites were risk factors for adverse events in AIH (all P < 0.05) and were associated with disease progression, and the multivariate Cox regression analysis showed that hypoproteinemia and ascites were independent risk factors for adverse events (all P < 0.05).  Conclusion  There is a relatively high detection rate of OBI in AIH patients, and the presence of OBI may accelerate the progression of AIH.

     

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  • [1]
    MANNS MP, CZAJA AJ, GORHAM JD, et al. Diagnosis and management of autoimmune hepatitis[J]. Hepatology, 2010, 51(6): 2193-2213. DOI: 10.1002/hep.23584.
    [2]
    GRØNBÆK L, VILSTRUP H, JEPSEN P. Autoimmune hepatitis in Denmark: incidence, prevalence, prognosis, and causes of death. A nationwide registry-based cohort study[J]. J Hepatol, 2014, 60(3): 612-617. DOI: 10.1016/j.jhep.2013.10.020.
    [3]
    RAIMONDO G, ALLAIN JP, BRUNETTO MR, et al. Statements from the Taormina expert meeting on occult hepatitis B virus infection[J]. J Hepatol, 2008, 49(4): 652-657. DOI: 10.1016/j.jhep.2008.07.014.
    [4]
    GEORGIADOU SP, ZACHOU K, LIASKOS C, et al. Occult hepatitis B virus infection in patients with autoimmune liver diseases[J]. Liver Int, 2009, 29(3): 434-442. DOI: 10.1111/j.1478-3231.2008.01851.x.
    [5]
    CHEN XX, XIANG KH, ZHANG HP, et al. Occult HBV infection in patients with autoimmune hepatitis: A virological and clinical study[J]. J Microbiol Immunol Infect, 2020, 53(6): 946-954. DOI: 10.1016/j.jmii.2019.04.009.
    [6]
    ALVAREZ F, BERG PA, BIANCHI FB, et al. International autoimmune hepatitis group report: review of criteria for diagnosis of autoimmune hepatitis[J]. J Hepatol, 1999, 31(5): 929-938. DOI: 10.1016/s0168-8278(99)80297-9.
    [7]
    HENNES EM, ZENIYA M, CZAJA AJ, et al. Simplified criteria for the diagnosis of autoimmune hepatitis[J]. Hepatology, 2008, 48(1): 169-176. DOI: 10.1002/hep.22322.
    [8]
    Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Consensus on the diagnosis and management of autoimmune hepatitis (2015)[J]. J Clin Hepatol, 2016, 32(1): 9-22. DOI: 10.3969/j.issn.1001-5256.2016.01.002.

    中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会. 自身免疫性肝炎诊断和治疗共识(2015)[J]. 临床肝胆病杂志, 2016, 32(1): 9-22. DOI: 10.3969/j.issn.1001-5256.2016.01.002.
    [9]
    FANG Y, SHANG QL, LIU JY, et al. Prevalence of occult hepatitis B virus infection among hepatopathy patients and healthy people in China[J]. J Infect, 2009, 58(5): 383-388. DOI: 10.1016/j.jinf.2009.02.013.
    [10]
    YIP TC, WONG GL. Current knowledge of occult hepatitis B infection and clinical implications[J]. Semin Liver Dis, 2019, 39(2): 249-260. DOI: 10.1055/s-0039-1678728.
    [11]
    TORBENSON M, THOMAS DL. Occult hepatitis B[J]. Lancet Infect Dis, 2002, 2(8): 479-486. DOI: 10.1016/s1473-3099(02)00345-6.
    [12]
    FANG Y, TENG X, XU WZ, et al. Molecular characterization and functional analysis of occult hepatitis B virus infection in Chinese patients infected with genotype C[J]. J Med Virol, 2009, 81(5): 826-835. DOI: 10.1002/jmv.21463.
    [13]
    POLLICINO T, CACCIOLA I, SAFFIOTI F, et al. Hepatitis B virus PreS/S gene variants: pathobiology and clinical implications[J]. J Hepatol, 2014, 61(2): 408-417. DOI: 10.1016/j.jhep.2014.04.041.
    [14]
    KIM H, LEE SA, KIM DW, et al. Naturally occurring mutations in large surface genes related to occult infection of hepatitis B virus genotype C[J]. PLoS One, 2013, 8(1): e54486. DOI: 10.1371/journal.pone.0054486.
    [15]
    RIDOLA L, ZULLO A, LAGANÀ B, et al. Hepatitis B (HBV) reactivation in patients receiving biologic therapy for chronic inflammatory diseases in clinical practice[J]. Ann Ist Super Sanita, 2021, 57(3): 244-248. DOI: 10.4415/ANN_21_03_08.
    [16]
    XIA Y, GUO H. Hepatitis B virus cccDNA:Formation, regulation and therapeutic potential[J]. Antiviral Res, 2020, 180: 104824. DOI: 10.1016/j.antiviral.2020.104824.
    [17]
    XIA Y, GUO H. Hepatitis B virus cccDNA: Formation, regulation and therapeutic potential[J]. Antiviral Res, 2020, 180: 104824. DOI: 10.1016/j.antiviral.2020.104824.
    [18]
    SI LL, LI XD, LI L, et al. Inhibitory effect of Suduxing extracts on covalently closed circular DNA of hepatitis B virus[J/CD]. Chin J Exp Clin Infect Dis(Electronic Edition), 2020, 14(4): 265-271. DOI: 10.3877/cma.j.issn.1674-1358.2020.04.001.

    思兰兰, 李晓东, 李乐, 等. 复方肃毒星提取物抑制乙型肝炎病毒cccDNA的作用[J/CD]. 中华实验和临床感染病杂志(电子版), 2020, 14(4): 265-271. DOI: 10.3877/cma.j.issn.1674-1358.2020.04.001.
    [19]
    TAN N, LUO H, XU XY. Significance of hepatitis B virus pregenomic RNA in the progression of chronic hepatitis B[J]. J Clin Hepatol, 2018, 34(10): 2221-2223. DOI: 10.3969/j.issn.1001-5256.2018.10.035.

    谭宁, 罗皓, 徐小元. HBV pgRNA在慢性乙型肝炎进程中的可能意义[J]. 临床肝胆病杂志, 2018, 34(10): 2221-2223. DOI: 10.3969/j.issn.1001-5256.2018.10.035.
    [20]
    CACCIOLA I, POLLICINO T, SQUADRITO G, et al. Occult hepatitis B virus infection in patients with chronic hepatitis C liver disease[J]. N Engl J Med, 1999, 341(1): 22-26. DOI: 10.1056/NEJM199907013410104.
    [21]
    GIANNINI E, CEPPA P, BOTTA F, et al. Previous hepatitis B virus infection is associated with worse disease stage and occult hepatitis B virus infection has low prevalence and pathogenicity in hepatitis C virus-positive patients[J]. Liver Int, 2003, 23(1): 12-18. DOI: 10.1034/j.1600-0676.2003.01742.x.
    [22]
    CHAN HL, TSANG SW, LEUNG NW, et al. Occult HBV infection in cryptogenic liver cirrhosis in an area with high prevalence of HBV infection[J]. Am J Gastroenterol, 2002, 97(5): 1211-1215. DOI: 10.1111/j.1572-0241.2002.05706.x.
    [23]
    FUKUDA R, ISHIMURA N, NⅡGAKI M, et al. Serologically silent hepatitis B virus coinfection in patients with hepatitis C virus-associated chronic liver disease: clinical and virological significance[J]. J Med Virol, 1999, 58(3): 201-207. DOI: 10.1002/(sici)1096-9071(199907)58:3<201::aid-jmv3>3.0.co;2-2.
    [24]
    BRANCO F, MATTOS AA, CORAL GP, et al. Occult hepatitis B virus infection in patients with chronic liver disease due to hepatitis C virus and hepatocellular carcinoma in Brazil[J]. Arq Gastroenterol, 2007, 44(1): 58-63. DOI: 10.1590/s0004-28032007000100013.
    [25]
    MIURA Y, SHIBUYA A, ADACHI S, et al. Occult hepatitis B virus infection as a risk factor for hepatocellular carcinoma in patients with chronic hepatitis C in whom viral eradication fails[J]. Hepatol Res, 2008, 38(6): 546-556. DOI: 10.1111/j.1872-034X.2007.00316.x.
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