Progress in the Study of Combined Immunosuppression in Patients with Cryptogenic Hepatitis B
DOI:
https://doi.org/10.53469/jcmp.2025.07(02).27Keywords:
Cryptogenic hepatitis B virus infection, Immunosuppression, Hepatitis B virus reactivationAbstract
Occult hepatitis B virus infection (OBI), as a special form of HBV infection, refers to HBsAg-negative body, but can be detected in liver tissues and/or serum with a low load of HBV DNA, often less than 200 IU/mL, and is still pathogenic and infectious. OBI does not lead to obvious damage to the liver in general, but when it is necessary to receive immunosuppressive treatment for coexisting diseases, reactivation of hepatitis B virus may occur, with the risk of developing into viral hepatitis, cirrhosis and liver cancer. In general, OBI does not cause significant liver damage, but when immunosuppressive therapy is required due to other diseases, reactivation of hepatitis B virus may occur, and there is a risk of developing viral hepatitis, cirrhosis and hepatocellular carcinoma. In this paper, we review the definition of OBI, its clinical characteristics, and the related research progress when receiving immunosuppressive therapy under different circumstances.
References
WORLD HEALTH O. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021: accountability for the global health sector strategies 2016–2021: actions for impact [M]. Geneva: World Health Organization, 2021.
RAIMONDO G, ALLAIN J P, BRUNETTO M R, et al. Statements from the Taormina expert meeting on occult hepatitis B virus infection [J]. J Hepatol, 2008, 49(4): 652-657.
POLLICINO T, SAITTA C, RAIMONDO G. Hepatocellular carcinoma: the point of view of the hepatitis B virus [J]. Carcinogenesis, 2011, 32(8): 1122-1132.
BRéCHOT C. Pathogenesis of hepatitis B virus-related hepatocellular carcinoma: old and new paradigms [J]. Gastroenterology, 2004, 127(5 Suppl 1): S56-61.
EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection [J]. J Hepatol, 2017, 67(2): 370-398.
LEVRERO M, POLLICINO T, PETERSEN J, et al. Control of cccDNA function in hepatitis B virus infection [J]. J Hepatol, 2009, 51(3): 581-592.
ZERBINI A, PILLI M, BONI C, et al. The characteristics of the cell-mediated immune response identify different profiles of occult hepatitis B virus infection [J]. Gastroenterology, 2008, 134(5): 1470-1481.
RAIMONDO G, POLLICINO T, CACCIOLA I, SQUADRITO G. Occult hepatitis B virus infection [J]. J Hepatol, 2007, 46(1): 160-170.
HOLLINGER F B, SOOD G. Occult hepatitis B virus infection: a covert operation [J]. J Viral Hepat, 2010, 17(1): 1-15.
RAIMONDO G, LOCARNINI S, POLLICINO T, et al. Update of the statements on biology and clinical impact of occult hepatitis B virus infection [J]. Journal of Hepatology, 2019, 71(2): 397-408.
HOOFNAGLE J H, DUSHEIKO G M, SCHAFER D F, et al. Reactivation of chronic hepatitis B virus infection by cancer chemotherapy [J]. Ann Intern Med, 1982, 96(4): 447-449.
SHI Y, WU Y H, WU W, et al. Association between occult hepatitis B infection and the risk of hepatocellular carcinoma: a meta-analysis [J]. Liver Int, 2012, 32(2): 231-240.
YIP T C, WONG G L. Current Knowledge of Occult Hepatitis B Infection and Clinical Implications [J]. Semin Liver Dis, 2019, 39(2): 249-260.
PISATURO M, ONORATO L, RUSSO A, COPPOLA N. Prevalence of occult HBV infection in Western countries [J]. J Med Virol, 2020, 92(12): 2917-2929.
CHEN J, LIU Y, ZHAO J, et al. Characterization of Novel Hepatitis B Virus PreS/S-Gene Mutations in a Patient with Occult Hepatitis B Virus Infection [J]. PLoS One, 2016, 11(5): e0155654.
KEEFFE E B. Hepatitis B virus reactivation with chemotherapy: diagnosis and prevention with antiviral prophylaxis [J]. Rev Gastroenterol Disord, 2004, 4(1): 46-48.
SATO K. [Immunosuppressive therapy or chemotherapy - induced reactivation of hepatitis B virus infection] [J]. Gan To Kagaku Ryoho, 2011, 38(2): 161-168.
MINDIKOGLU A L, REGEV A, SCHIFF E R. Hepatitis B virus reactivation after cytotoxic chemotherapy: the disease and its prevention [J]. Clin Gastroenterol Hepatol, 2006, 4(9): 1076-1081.
JI D, CAO J, HONG X, et al. Low incidence of hepatitis B virus reactivation during chemotherapy among diffuse large B-cell lymphoma patients who are HBsAg-negative/HBcAb-positive: a multicenter retrospective study [J]. Eur J Haematol, 2010, 85(3): 243-250.
YEO W, CHAN T C, LEUNG N W, et al. Hepatitis B virus reactivation in lymphoma patients with prior resolved hepatitis B undergoing anticancer therapy with or without rituximab [J]. J Clin Oncol, 2009, 27(4): 605-611.
LOK A S, LIANG R H, CHIU E K, et al. Reactivation of hepatitis B virus replication in patients receiving cytotoxic therapy. Report of a prospective study [J]. Gastroenterology, 1991, 100(1): 182-188.
STEINBERG J L, YEO W, ZHONG S, et al. Hepatitis B virus reactivation in patients undergoing cytotoxic chemotherapy for solid tumours: precore/core mutations may play an important role [J]. J Med Virol, 2000, 60(3): 249-255.
LUBEL J S, ANGUS P W. Hepatitis B reactivation in patients receiving cytotoxic chemotherapy: diagnosis and management [J]. J Gastroenterol Hepatol, 2010, 25(5): 864-871.
MORSICA G, ANCARANI F, BAGAGLIO S, et al. Occult hepatitis B virus infection in a cohort of HIV-positive patients: correlation with hepatitis C virus coinfection, virological and immunological features [J]. Infection, 2009, 37(5): 445-449.
MALAGNINO V, CERVA C, TETI E, et al. Poor CD4/CD8 ratio recovery in HBcAb-positive HIV patients with worse immune status is associated with significantly higher CD8 cell numbers [J]. Sci Rep, 2021, 11(1): 3965.
NEBBIA G, GARCIA-DIAZ A, AYLIFFE U, et al. Predictors and kinetics of occult hepatitis B virus infection in HIV-infected persons [J]. J Med Virol, 2007, 79(10): 1464-1471.
COHEN STUART J W, VELEMA M, SCHUURMAN R, et al. Occult hepatitis B in persons infected with HIV is associated with low CD4 counts and resolves during antiretroviral therapy [J]. J Med Virol, 2009, 81(3): 441-445.
MALAGNINO V, SALPINI R, TETI E, et al. Role of HBcAb Positivity in Increase of HIV-RNA Detectability after Switching to a Two-Drug Regimen Lamivudine-Based (2DR-3TC-Based) Treatment: Months 48 Results of a Multicenter Italian Cohort [J]. Viruses, 2023, 15(1).
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