血清HBs Ag阴性,但肝组织或血清HBV DNA长期存在,这种状态被称为隐匿性HBV感染(OBI)。由于实际HBV流行率和病毒流行株的地域性差异、所选取的研究人群的差异和不同检测方法的敏感性和特异性的差异,不同研究所得到的OBI的流行率有很大的差别。OBI的形成机制尚未完全阐明,可能有多种病毒学因素、宿主因素参与其中。OBI能通过输血、分娩和肝移植等方式进行传播,引起新发感染。当宿主免疫功能下降或应用免疫抑制性药物时,OBI可以复燃,恢复经典的血清学表现。OBI引起的轻微但持续的坏死性炎症可以促进肝脏疾病的进展,并且可以通过直接或者间接的机制增加肿瘤的发生风险。临床上需要建立更敏感的检测方法诊断OBI,以减少OBI相关的潜在威胁,帮助医师合理采取治疗措施,延缓病情进展。
Occult hepatitis B virus (HBV) infection (OBI) is defined as tile status with persistent serum FIBsAg negative, but with serum/intrahepatic HBV DNA positive. Due to the differences in prevalence of HBV infection,prevalent viral strains, study samples,as well as sensitivity and specificity of methodology,the available data of OBI prevalence quite varied. The pathogenesis of OBI has not been fully elucidated. It is a complex process involving muhipte virological and host factors. OBI can be transmitted through blood transfusian,parturition and liver transplantation to cause de novo infection. Immune dysfunction andapplication of agents can lead to OBI reactivation and recurrence of typical serological evidence. The slight but persistent necrn-inflammation can promote the progression of liver disease and increase the risk of tumorigenesis. In clinic,more sensitive detection methods are needed for diagnosis of OBI to reduce OBI-related potential threat and help clinicians to take reasonable managements to slow the progression of the disease.