Occult hepatitis B virus infection in patients with autoimmune liver diseases

Abstract

Based mainly on serum HBV-DNA, we found a significant proportion of autoimmune liver disease patients with occult HBV compared with donors. However, taking into account our results in a small number of liver tissues, it should be emphasized that occult HBV could be even higher when both serum and liver specimens are investigated. Occult HBV does not seem to affect the clinical and laboratory features of the diseases, while AIH patients with occult HBV under immunosuppression do not deteriorate during follow-up.

Development of occult hepatitis B viral infection in pregnancy: implications for antenatal screening in women from endemic areas

“…The change in total HBcAb status from positive to only equivocal and the absence of a measurable IgM HBcAb response coincident with the detection of HBV DNA in peripheral blood together point to an important role played by reduction of virus-specific immunity, rather than the possibility of new HBV exposure, in the development of the occult infection in our patient, in whom the peak HBV DNA level in pregnancy was comparable to that recently reported in patients from an endemic area who developed occult HBV infection in the context of pharmacological immunosuppression. 2 The risk of occult HBV infection developing in this latter circumstance was 6% in the only reported analysis to date. 2 The prevalence of occult HBV infection developing in pregnancy is currently unknown.…”

“…2 The risk of occult HBV infection developing in this latter circumstance was 6% in the only reported analysis to date. 2 The prevalence of occult HBV infection developing in pregnancy is currently unknown. Data regarding this, along with assessment of predisposing factors for this phenomenon, its possible impact on maternal health and the risk of vertical transmission, are required so that implications for current antenatal screening strategies that do not include measurement of HBV DNA in peripheral blood can be properly determined.…”

“…Liver ultrasonography remained normal. Given instances of occult HBV infection becoming evident for the first time in patients from endemic areas undergoing immunosuppressive therapy 2 and because both pregnancy is a condition associated with immune suppression 3,4 and vertical transmission from mother to baby may occur in the occult HBV infection setting, 5,6 it was decided to reassess for the possibility of the development of occult HBV infection should the patient became pregnant.…”

“…The absence of measurable HBsAg and the relatively low level of viral replication, as reflected by circulating HBV DNA concentrations, in occult HBV infection are mostly due to a vigorous host cellular immune response that limits replication activity and viral gene expression, rather than the result of infection with replication-defective or HBsAg-escape mutants 1 and instances of development of occult infection under the influence of pharmacological immunosuppression have recently been reported in patients from areas endemic for HBV, and, hence, at risk of previous exposure. 2 Pregnancy is a condition associated with suppression of cellular immunity, 3,4 but whether virus-specific immunity may be suppressed to an extent sufficient to allow occult HBV infection to develop is currently unknown. This is an issue of potential relevance not only to the mother's health but also because vertical transmission has been reported both clinically and in an animal model in the occult HBV infection setting.…”

Acute liver failure caused by concurrent autoimmune hepatitis and hepatitis B in a 16-year old girl

“…The occult HBV infections did not promote progression of AIH. Moreover, no patient had a reactivation of HBV infection during immunosuppressive treatment [4] . To date, no HBV infection with concurrent AIH has been reported in chil dren.…”