A 2010 update on occult hepatitis B infection

Occult hepatitis B virus infection is a challenging issue whose virological and clinical relevance has been a source of long-lasting debate. By definition, OBI is characterized by the persistence of HBV-DNA in the liver tissue (and in some cases also in the serum) in absence of HBsAg. According to t...

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Bibliographic Details
Published in:Pathologie biologie (Paris) 2010-08, Vol.58 (4), p.254-257
Main Authors: Raimondo, G., Pollicino, T., Romanò, L., Zanetti, A.R.
Format: Article
Language:English
Subjects:
Anti-HBc
DNA, Viral - analysis
HBV
HBV-DNA
Hepatitis B
Hepatitis B Surface Antigens - analysis
Hepatitis B virus - genetics
Hepatitis B virus - immunology
Hepatitis B, Chronic - diagnosis
Hepatitis B, Chronic - transmission
Hepatitis B, Chronic - virology
Humans
Hépatite B
IBO
Infection occulte VHB
Liver - virology
OBI
Occult HBV infection
Organ Transplantation - adverse effects
Serologic Tests
Transfusion Reaction
VHB
VHB-ADN
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Summary:Occult hepatitis B virus infection is a challenging issue whose virological and clinical relevance has been a source of long-lasting debate. By definition, OBI is characterized by the persistence of HBV-DNA in the liver tissue (and in some cases also in the serum) in absence of HBsAg. According to the HBV serological profile, OBI may be antibody (anti-HBc alone or together with anti-HBs) positive (seropositive OBI) or antibody negative (seronegative OBI). OBI is a complex biological entity with possible relevant clinical implications, mainly related to the intrahepatic persistence of viral cccDNA and to a strong suppression of viral replication and gene expression. Clinical observations suggest that OBI carriers may be a source of HBV transmission through blood transfusion or orthotopic liver transplantation (OLT). The state of suppression of viral replication and gene expression may be discontinued when an immunosuppressive status occurs, leading to typical hepatitis B with severe – and some times – fulminant course. The long-lasting persistence of the virus in the liver may provoke a very mild but continuing necro-inflammation that (if other causes of liver damage cohexist) may contribute over time to the progression of the chronic liver damage towards cirrhosis. In addition, OBI is supposed to be an important risk factor to HCC development since it maintains the pro-oncogenic properties typical of the overt infection. L’infection occulte de virus de l’hépatite B (OBI) est un problème difficile, dont l’importance virologique et clinique a été une source de débat pendant longtemps. Par définition, l’OBI est caractérisée par la persistance de VBH-ADN dans le tissu du foie (et dans quelques cas aussi dans le sérum) dans le cas d’absence de HBsAg. Selon le profile sérologique du VBH (virus de l’hépatite B), l’OBI peut être positive aux anticorps (anti-HBc seul ou avec anti-HBs) (OBI séropositive) ou négative aux anticorps (OBI séronégative). L’OBI est une entité biologique complexe avec des implications cliniques considérables possibles, sur la base surtout de la persistance intrahépatique d’ADNccc viral et d’une forte suppression de réplication virale et expression des gènes. Les observations cliniques indiquent que les porteurs d’OBI peuvent être une source de transmission de VBH par transfusion de sang ou transplant orthotopique de foie. L’état de suppression de la réplication virale et de l’expression des gènes peut être interrompu dans le cas d’un état
ISSN:0369-8114
1768-3114
DOI:10.1016/j.patbio.2010.02.003