Patients with Coexistence of Circulating Hepatitis B Surface Antigen and Its Antibody May Have a Strong Predisposition to Virus Reactivation During Immunosuppressive Therapy: A Hypothesis.
Patients with Coexistence of Circulating Hepatitis B Surface Antigen and Its Antibody May Have a Strong Predisposition to Virus Reactivation During Immunosuppressive Therapy: A Hypothesis.
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循环乙型肝炎表面抗原及其抗体共存的患者在免疫抑制治疗期间可能有很强的病毒再激活倾向：一个假设
DOI：
10.12659/msm.905033
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发表时间：
2017-12-17
期刊：
影响因子：
--
通讯作者：
Dai L
中科院分区：
文献类型：
--
作者：
Chen YL;Mo YQ;Zheng DH;Ma JD;Jing J;Dai L
B型肝炎病毒（HBV）再活化是接受免疫抑制药物治疗的患者公认的并发症。尽管美国胃肠病学会在2015年提出的抗病毒预防的建议侧重于不同免疫抑制药物的风险分层，但在临床实践中也值得识别HBV再激活的风险因素。最近的研究表明，共存的循环乙型肝炎表面抗原（HBsAg）及其抗体（抗-HB）的罕见血清学模式与乙型肝炎病毒基因组基础核心启动子（BCP）区域的双突变（A1762 T/G1764 A）有关，这对乙型肝炎病毒复制至关重要。在这里，我们描述了类风湿性关节炎（RA）患者与共存的HBsAg和抗-HBs在我们的医疗中心，谁开发的免疫抑制药物治疗期间HBV再激活。HBV基因组DNA测序分析显示BCP区存在三重突变（A1762 T、G1764 A和T1753 V），这可能进一步增强HBV的复制能力。因此，一个新的假设是先进的第一次，患者与HBsAg和抗-HBs共存可能有很强的易感性，由于特定的BCP突变的HBV再激活。如果这一假设是正确的，则在风湿性疾病患者的HBV筛查中同时检测HBsAg和抗-HBs是合理的，并可快速识别出HBV再激活风险高的患者。需要进一步的对照研究来证实这一假设。
Hepatitis B virus (HBV) reactivation is a well-recognized complication in patients who undergo immunosuppressive drug therapy. Although the recommendation of antiviral prophylaxis made by the American Gastroenterological Association in 2015 focuses on the risk stratification of different immunosuppressive drugs, risk factors for HBV reactivation are also worth identifying in clinical practice. Recent studies have shown that the uncommon serological pattern of coexistent circulating HBV surface antigen (HBsAg) and its antibody (anti-HBs) was associated with double mutations (A1762T/G1764A) in the basal core promoter (BCP) region of the HBV genome, which is critical for HBV replication. Here, we depicted rheumatoid arthritis (RA) patients with coexistent HBsAg and anti-HBs in our medical center, who developed HBV reactivation during immunosuppressive drug therapy. DNA sequencing analysis of the HBV genome revealed triple mutations (A1762T, G1764A, and T1753V) in the BCP region, which could further enhance the ability of HBV replication. Hence, a novel hypothesis is advanced for the first time that patients with coexistent HBsAg and anti-HBs may have a strong predisposition to HBV reactivation due to specific BCP mutations. This hypothesis would, if correct, justify the concurrent detection of HBsAg and anti-HBs in HBV screening in patients with rheumatic diseases and quickly recognize patients with high risk of HBV reactivation. Further controlled studies are needed to confirm this hypothesis.
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影响因子：
2.3
作者：
Mo YQ;Liang AQ;Ma JD;Chen LF;Zheng DH;Schumacher HR;Dai L
通讯作者：
Dai L
影响因子：
168.9
作者：
Lozano, Rafael;Naghavi, Mohsen;Murray, Christopher J. L.
通讯作者：
Murray, Christopher J. L.
中国慢性乙型肝炎病毒患者乙型肝炎表面抗原与抗-HBs共存与C基因型及S、P基因逆转录酶区突变有关
影响因子：
2.7
作者：
Liu, Weiwei;Hu, Tingting;Guan, Ming
通讯作者：
Guan, Ming
中国HBsAg和抗HBs抗体共存患者的HBV S蛋白序列分析
影响因子：
12.7
作者：
Ding, Feng;Yu, Hong-Gang;Yu, Jie-Ping
通讯作者：
Yu, Jie-Ping
DOI：
10.1093/jnci/djp180
发表时间：
2009-08-05
期刊：
Journal of the National Cancer Institute
影响因子：
--
作者：
Liu S;Zhang H;Gu C;Yin J;He Y;Xie J;Cao G
通讯作者：
Cao G