HEPATITIS-B VIRUS REACTIVATION OR REINFECTION ASSOCIATED WITH HIV-1 INFECTION
HEPATITIS-B VIRUS REACTIVATION OR REINFECTION ASSOCIATED WITH HIV-1 INFECTION
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DOI：
10.1097/00002030-198812000-00006
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发表时间：
1988-12-01
期刊：
影响因子：
3.8
通讯作者：
TEDDER, RS
中科院分区：
文献类型：
--
作者：
WAITE, J;GILSON, RJC;TEDDER, RS
在急性乙肝病毒感染后，大多数人会产生抗乙肝病毒表面抗体(抗-HBs)和核心抗原(抗-HBc)。流行率研究表明，在没有检测到抗-HBs的情况下，有10%-18%的人会出现抗-HBc。我们报告了四个这样的病例，都是血清抗-HBc持续存在的，他们有证据表明乙肝病毒复制第二阶段活跃，表现为血清乙肝表面抗原(HBs)的再现。在一名患者中，HBs Ag亚型的差异表明，第二个HBs Ag阳性时期是由于再次感染。在其他情况下，重新激活也可以解释这些发现。所有病例在乙肝表面抗原重现时均为抗-HIV-1阳性。有实验证据表明，抗-HBc对乙肝病毒感染有保护作用；然而，这可能需要完整的细胞免疫才能有效。HIV-1感染可能会使这些患者容易再次感染。或者，一些抗-HBc阳性但未检测到抗-HBs的患者可能存在潜在的乙肝病毒感染。与HIV-1感染相关的免疫抑制可能允许重新激活。
Following acute hepatitis B virus (HBV) infection, most individuals develop antibodies to HBV surface (anti-HBs) and core antigen (anti-HBc). Prevalence studies have shown that 10–18% develop anti-HBc in the absence of detectable anti-HBs. We report four such cases, all with persistence of serum anti-HBc, who had evidence of a second period of active HBV replication as demonstrated by the reappearance of serum hepatitis B surface antigen (HBsAg). In one patient, an HBsAg subtype difference indicated that the second period of HBsAg-positivity was due to a reinfection. In the other cases, reactivation may also explain the findings. All cases were anti-HIV-1 seropositive at the time of reappearance of HBsAg. There is experimental evidence that anti-HBc has a protective effect against HBV infection; however, this may require intact cell-mediated immunity to be effective. HIV-1 infection may render such patients susceptible to reinfection. Alternatively, some patients with anti-HBc, but without detectable anti-HBs may have latent HBV infection. Immunosuppression associated with HIV-1 infection may allow reactivation.