Occult Hepatitis B Infection in Patients Infected With HIV: Report of Two Cases of Hepatitis B Reactivation and Prevalence in a Hospital Cohort
Occult Hepatitis B Infection in Patients Infected With HIV: Report of Two Cases of Hepatitis B Reactivation and Prevalence in a Hospital Cohort
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DOI：
10.1002/jmv.21685
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发表时间：
2010-02-01
影响因子：
12.7
通讯作者：
Venard, V.
中科院分区：
文献类型：
--
作者：
Bloquel, B.;Jeulin, H.;Venard, V.
合并感染人类免疫缺陷病毒（HIV）和B型肝炎病毒（HBV）的患者尤其有B型肝炎再激活的风险。两例患者感染HIV与分离的抗HBc抗体谁经历了HBV再激活的描述。在这两个病例中，根据HIV基因型耐药谱，在患者的高效抗逆转录病毒治疗（HAART）中停用具有抗HBV活性的抗逆转录病毒治疗后发生HBV再激活。因此，从383例HIV感染者的血浆样本进行了测试，以评估隐匿性HBV感染的流行病学在南希医院的传染病科单位通过调查血清学模式和HBV复制。45%（172/383）的患者曾接触过HBV。48例患者（48/383，12%）检出抗-HBc抗体，其中2例HBV-DNA阳性。由于75%（288/383）的患者接受HAART治疗，包括至少一种抗HBV药物，隐匿性HBV感染可能无法识别。在HIV感染的情况下，所有患者都应进行HBV感染筛查，了解HBV状态以及监测HBV病毒载量对于预防HBV再激活至关重要。在接受HAART的合并感染患者中，应考虑继续使用具有抗HBV活性的药物，因为停止治疗与HBV再激活的风险相关。至少，在这种情况下，需要密切监测HBV病毒载量。医学病毒学杂志82：206-212，2010. (C)2009 Wiley-Liss，Inc.
Patients co-infected with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) are particularly at risk of hepatitis B reactivation. Two cases of patients infected with HIV with isolated anti-HBc antibodies who had experienced an HBV reactivation are described. In the two cases HBV reactivation occurred after withdrawal of antiretroviral treatment with anti-HBV activity from the patients' highly active antiretroviral therapy (HAART), in accordance with HIV genotypic resistance profiles. Consequently, plasma samples from 383 patients infected with HIV were tested to assess the prevalence of occult HBV infection in the Infectious Diseases Department Unit of Nancy Hospital by investigating serological patterns and HBV replication. Forty-five percent (172/383) of patients had had previous contact with HBV. Isolated anti-HBc antibodies were observed in 48 patients (48/383, 12%) and, among these, 2 were HBV-DNA positive. Since 75% (288/383) of the patients were treated with HAART, including at least one drug active against HBV, occult HBV infection was perhaps unrecognized. In cases of HIV infection, all patients should be screened for HBV infection and the knowledge of HBV status as well as the monitoring of HBV viral load are essential in preventing HBV reactivation. Consideration should be given to the continuation of drugs with anti-HBV activity in co-infected patients receiving HAART, as cessation of therapy is associated with a risk of HBV reactivation. At least, close monitoring of the HBV viral load is warranted in such situations. J. Med. Virol. 82:206-212, 2010. (C) 2009 Wiley-Liss, Inc.