Advances In Occult Hepatitis B Viruinfection And Immunosuppression

Occult hepatitis B virus infection was commonly described as HBV DNA could be check outed in the liver and small amounts (<200 IU/ml) HBV DNA in blood. Most OBI is characterized by HBsAg negative, HBcAb positive and/or HBsAb positive, seldom whole HBV markers negative. HBV infection is persistence because cccDNA exist inside the infected hepatocytes, which can be a storage for future infection. In some especially states OBI has important clinical value, for example:organ transplantation, dialysis, hematopoietic stem cell transplantation, immunosuppressive or chemotherapy therapy, blood transfusion, immunosuppression induced by cancer and HIV, and co-infection with chronic HCV、HIV and so on. OBI is harmless under the normal immune regulation, but it may be reactivated when the immunesuppression duing to related causes, thereby increasing liver disease condition. OBI often happens when hematologic diseases immunosuppression therapy and solid cancers chemotherapy. Nearly 20% cases appeared OBI reactivation, which may contribute to severe clinical effect, and so much so that life-security can not be guaranteed. It is recommend to prophylactic use of nucleoside (acid) analogues for those patients with organ transplantation and hematopoietic stem cell transplantation; as well as hematological malignancies using high-intensity immunization suppression therapy(when treated with large doses of rituximab and glucocorticoids, or lengthen treatment). It is needed to closely monitor the HBV serological markers of hepatitis B surface antigen and should be treatment with antiviral drugs as early as possible when serum HBV-DNA become detectable. This literature introduces the recent information of research for OBI, focusing on relationship between the OBI and immunosuppressive drug, treatment in different clinical conditions and strategies and management related to the prophylaxis of HBV reactivation.