Occult Hepatitis B Virus Infection and Liver Fibrosis in Chinese Patients

作者：Tang, Xi; Yang, Liu; Zhang, Panli; Wang, Cong; Luo, Shengxue; Liu, Bochao; Fu, Yongshui; Candotti, Daniel; Allain, Jean-Pierre; Zhang, Ling^*; Li, Chengyao^*; Li, Tingting^*

来源：JOURNAL OF INFECTIOUS DISEASES, 2023, 228(10): 1375-1384.

DOI：10.1093/infdis/jiad140

• Liver fibrosis
• occult HBV infection
• serum indexes
• viral biomarkers
• fibrosis progression

Hepatitis B surface antigen-negative, hepatitis B virus (HBV) DNA-positive occult HBV infection status appears associated with liver fibrosis; hepatitis B core antigen is correlated with elevated serum liver fibrosis indexes and may affect fibrotic progression in liver tissue. @@@ Background The impact of hepatitis B surface antigen (HBsAg)-negative/hepatitis B virus (HBV) DNA-positive occult HBV infection (OBI) on the severity of liver fibrosis remains unclear. Methods A total of 1772 patients negative for HBsAg but positive for antibody to hepatitis B core antigen (HBcAg), stratified by the presence or absence of OBI, were selected for long-term carriage leading to elevation of >= 2 of 4 liver fibrosis indexes-hyaluronic acid (HA), laminin, type III procollagen peptide (PCIII), and type IV collagen (CIV)-at testing in a Chinese hospital. Patients were tested for serum viral load, HBV markers, and histopathological changes in liver biopsy specimens. Results OBI was identified in 148 patients with liver fibrosis (8.4%), who had significantly higher levels of HA, laminin, PCIII, and CIV than 1624 fibrotic patients without OBI (P < .05). In 36 patients with OBI who underwent liver biopsy, significant correlations were observed between OBI viral load and serum HA levels (P = .01), PCIII levels (P = .01), and pathological histological activity index (HAI) scores (P < .001), respectively; HAI scores and PCIII levels (P = .04); HBcAg immunohistochemical scores and HA levels (P < .001); and HBcAg immunohistochemical scores and PCIII levels (P = .03). Positive fluorescent in situ hybridization results were significantly more frequent in patients with OBIs (80.6% vs 37.5% in those without OBIs). Among patients with OBIs, HBcAg was detected in the liver tissue in 52.8% and HBsAg in 5.6%. Conclusions OBI status appears to be associated with liver fibrosis severity.

• 单位
  1; 南方医科大学