bloodjourГематология и трансфузиологияRussian journal of hematology and transfusiology0234-57302411-3042ООО Издательский дом «Практика»10.25837/HAT.2018.68..2..007bloodjour-98Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS OF LITERATUREЛАТЕНТНАЯ ФОРМА ИНФЕКЦИИ, ВЫЗВАННАЯ ВИРУСОМ ГЕПАТИТА BOCCULT FORM OF INFECTION CAUSED BY THE HEPATITIS B VIRUShttps://orcid.org/0000-0003-4668-9379ТуполеваT. A.TupolevaT. A.

Туполева Татьяна Алексеевна, кандидат медицинских наук, заведующая отделом вирусологической диагностики, врач-вирусолог ФГБУ «НМИЦ гематологии» Минздрава России, 125167, Москва

ID: 6505936805

Tupoleva Tatiana A., MD, PhD, head of virology diagnostic department, physician virologist of National Research Centerfor Hematology, Moscow, 125167

ID: 6505936805

ttupoleva@mail.ruФГБУ «Национальный медицинский исследовательский центр гематологии» Минздрава России, МоскваРоссияNational Research Center for Hematology, MoscowRussian Federation201821042019632166173Copyright © Туполева T.A., 20192019Туполева T.A.Tupoleva T.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.htjournal.ru/jour/article/view/98

В обзоре представлены данные литературы, отражающие характеристику, формирование, особенности течения, диагностики и профилактики латентной формы инфекции, вызванной вирусом гепатита B (ВГВ). Латентная форма вирусного гепатита B (ЛГВ) характеризуется низким уровнем репликации ВГВ, когда ДНК вируса выявляется в печени в низких концентрациях (менее 200 МЕ/мл) и может не обнаруживаться в сыворотке, но могут присутствовать антитела к ядерному белку (анти-НВс) и/или поверхностному (антиHBs) белку ВГВ. В большинстве случаев ЛГВ вызвана вирусом, геномы которого репликативно компетентны и сопоставимы с генетической гетерогенностью изолятов вируса от лиц с HBsAg-положительным гепатитом B. В индукцию и поддержание латентной формы инфекции вовлечены факторы хозяина. Клиническое выздоровление при инфекции ВГВ отражает не полную эрадикацию вируса, а лишь способность иммунной системы держать под контролем репродукцию оставшихся в печени вирусов после клинического разрешения болезни. Многочисленные клинические исследования показывают, что любые условия, вызывающие иммуносупрессию, могут спровоцировать реактивацию ЛГВ с появлением типичного серологического профиля активной инфекции. Клиническое значение латентной инфекции ВГВ определяется тремя ключевыми моментами: 1) передача вируса в основном происходит при переливании крови и трансплантации печени с последующим развитием острого гепатита B у реципиента; 2) на фоне иммуносупрессии возможна реактивация ЛГВ; 3) латентная инфекция ВГВ способствует прогрессированию хронических заболеваний печени другой этиологии и играет определенную роль в гепатоканцерогенезе. Тестирование на анти-HBc является простой мерой предосторожности для предотвращения передачи ВГВ при переливании крови, особенно у пациентов с ослабленным иммунитетом. Использованы 60 источников литературы, из них 3 отечественных и 57 зарубежных, представленных в следующих информационных системах: PubMed, Google Scholar, Scopus, Springer, The Cochrane Library, Wiley Online Library, РИНЦ.

This paper reviews the literature on occult hepatitis B virus (HBV) infection (OBI), discussing its definition, pathogenesis, diagnosis and prevention. OBI is characterized by a low level of HBV replication, when the viral DNA is detected in the liver at low concentrations (< 200 IU/ml) and may be undetectable in serum, while antibodies to the HBV core protein (anti-HBc) and/or to its surface protein (anti-HBs) may be present. In most cases, OBI is caused by the virus whose genome is replicatively competent and comparable to the genomes isolated from individuals with HBsAgpositive infection. Host factors are strongly involved in the induction and maintenance of an occult form of infection. Clinical recovery from HBV infection does not imply complete eradication of the virus, but only the ability of the immune system to keep reproduction of the remaining virus in the liver under control. Numerous clinical studies have shown that any immunosuppressive factors may trigger HBV reactivation producing a typical serological profile of active infection. The clinical significance of OBI is summarized by the following three key points: 1) the “occult” virus can be transmitted, mainly with blood transfusions or liver transplantation, followed by development of acute hepatitis B in the recipient; 2) HBV can get reactivated during immunosuppression, and 3) latent HBV infection contributes to the progression of other chronic liver diseases and plays a role in hepatocarcinogenesis. Testing for anti-HBc is a simple precautionary measure to prevent transmission of HBV during blood transfusion, especially in immunocompromised patients. This review is based on 60 publications, 3 Russian and 57 foreign, retrieved from by the following databases: PubMed, Google Scholar, Scopus, Springer, Cochrane Library, Wiley Online Library, and Russian Science Citation Index.

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The authors declare that there are no conflicts of interest present.