Persistence of Occult Hepatitis B after Removal of the Hepatitis B Virus–Infected Liver

Ciesek, Sandra; Helfritz, Fabian; Lehmann, Ulrich; Becker, Thomas; Strassburg, Christian P.; Neipp, Michael; Ciner, Ayse; Fytili, P.; Tillmann, Hans L.; Manns, Michael P.; Wedemeyer, Heiner

doi:10.1086/525286

Cited by 30 publications

(56 citation statements)

References 16 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The significance of OHB in post-OLT (orthotropic liver transplantation) settings is controversial. Upon intrahepatic HBV DNA analysis, some patients show high levels of liver or serum HBV DNA and a high rate of reactivation (96,97), whereas, others show low HBV-DNAHBV levels of reactivation rates (93,98,99). However, it is postulated that most (if not all) researchers believe that OHB can be found in most recipients of livers from HBsAg-negative and antiHBc-positive liver donors.…”

Section: Transplantationmentioning

confidence: 99%

“…However, it is postulated that most (if not all) researchers believe that OHB can be found in most recipients of livers from HBsAg-negative and antiHBc-positive liver donors. Studies have indicated that HBV DNA remains detectable in the serum or PBMCs of patients who are anti-HBV-positive HBV DNA positive and and HBsAg-negative for several years after removal of the HBV-infected liver (99), and extra-hepatic reservoirs serving as the source of reinfection (96). The majority of cases in these studies indicate that the tapering or withdrawal of immunosuppression occurred before reverse seroconversion (100).…”

Section: Transplantationmentioning

confidence: 99%

See 1 more Smart Citation

Occult Hepatitis B (OBH) in Clinical Settings

et al. 2012

View full text Add to dashboard Cite

Occult HBV infection has received increasing attention in recent years. Although the impact of occult HB in patients has not been determined, it appears to accelerate the progression of liver fibrosis and cirrhosis, ultimately leading to HCC. Occult HBV infection is unexpectedly frequent, in particular in hepatitis C virus (HCV) and in human immunodeficiency virus (HIV) infected individuals. This phenomenon has also been reported in blood transfusion settings. Therefore, OBH has a great impact on public health issues regarding blood safety, HBV diagnosis, etc. Context:Occult hepatitis B (OHB), or persistent HBV DNA in patients who are hepatitis B surface antigen (HBsAg) negative, is a recently recognized entity. In an attempt to summarize the issues, this review presents an overview of the current proposed hypothesis on the clinical relevance and also updates the knowledge on the classification of OHB in different clinical settings. Evidence Acquisition: OHB could be found in different population and clinical backgrounds including: viral co-infections (with either human immunodeficiency or hepatitis C viruses), HBV chronic carriers, dialysis patients, transplantation settings and certain clinical situations (named in here: special clinical settings) with no apparent distinguishable clinical parameters. Results: The exact magnitude, pathogenesis, and clinical relevance of OHB are unclear. Even the possible role exerted by this cryptic infection on liver disease outcome, and hepatocellular carcinoma development remains unknown. Conclusions: monitoring of Individuals with positive anti-HBc, mass immunization programs and improvement in diagnostic tools seem to be important to control the probability of transmission of HBV through cryptic HBV infection.Published by Kowsar Corp, 2012. cc 3.0.

show abstract

Section: Transplantationmentioning

confidence: 99%

Section: Transplantationmentioning

confidence: 99%

Occult Hepatitis B (OBH) in Clinical Settings

et al. 2012

View full text Add to dashboard Cite

show abstract

“…22 HBV is a hepatotropic virus and replicates within hepatocytes, but it can also cause lymphotropism for lymphocytes in the peripheral blood, bone marrow, spleen, lymph nodes, and thymus. [23][24][25][26] This lymphotropism of HBV is a fundamental property favoring causality between HBV and B-cell malignancies.…”

Section: Casementioning

confidence: 99%

Splenic diffuse red-pulp small B-cell lymphoma associated with hepatitis B virus: a report of two cases

et al. 2016

View full text Add to dashboard Cite

CONTEXT: Splenic diffuse red-pulp small B-cell lymphoma is a rare disease, representing less than 1% of all non-Hodgkin lymphomas (NHL). This entity is characterized by involvement of bone marrow sinusoids and peripheral blood. The majority of cases are at an advanced stage when diagnosed. Its pathogenesis is still poorly understood. CASE REPORTS: We report on two patients with chronic non-replicating hepatitis B virus (HBV) who developed splenic diffuse red-pulp small B-cell lymphoma. Both of them were in stage IV at diagnosis and evolved with aggressive disease. Both of them achieved a complete response through chemotherapy, but one of them died due to infectious complications during bone marrow transplantation. The other decided not to undergo transplantation and continues not to show any evidence of disease today (three years after treatment). Some studies have shown a possible association between B-cell NHL and HBV. Nonetheless, the mechanism through which this oncogenic virus interacts with B-cell NHL is still poorly understood. HBV is lymphotropic and may insert into the host's genome, thus causing overexpression of oncogenes and downregulation of tumor suppressor genes. Therefore, chronic stimulation by HBV can increase B-cell proliferation, which promotes monoclonal expansion of these cells and results in malignancy. CONCLUSION: HBV may be implicated in the pathogenesis of this lymphoma, although no direct association between these two entities could be proved in the present study. Further investigations are necessary. RESUMO CONTEXTO:Linfoma esplênico difuso da polpa vermelha, de linfócitos B pequenos, é uma doença rara, representando menos do que 1% de todos os linfomas não Hodgkin. Essa entidade é caracterizada por envolvimento de sinusoides da medula óssea e sangue periférico. A maioria dos casos está em estádio avançado ao diagnóstico. Sua patogênese ainda é pouco compreendida. RELATOS DE CASOS:Reportamos dois pacientes com vírus da hepatite B (HBV) crônica não replicante que desenvolveram linfoma esplênico difuso da polpa vermelha, de linfócitos B pequenos. Ambos estavam em estádio IV ao diagnóstico e evoluíram com doença agressiva. Ambos alcançaram resposta completa com a quimioterapia, porém um deles evoluiu a óbito por intercorrências infecciosas durante o transplante de medula óssea e o outro optou por não realizar o transplante e encontra-se sem evidência de doença até os dias atuais (três anos após tratamento). Alguns estudos demonstraram a possível associação entre linfomas não Hodgkin B e HBV. Entretanto, o mecanismo pelo qual esse vírus oncogênico interage com linfoma não Hodgkin B ainda é pouco compreendido. HBV é linfotrópico e pode se inserir no genoma do receptor, causando superexpressão de oncogenes e downregulation de genes supressores tumorais. Portanto, o estímulo crônico pelo HBV pode aumentar a proliferação de células B, promovendo expansão monoclonal dessas células, resultando em malignidade. CONCLUSÃO: HBV pode estar implicado na patogênese desse linfoma, entretanto, u...

show abstract

“…Hervorzuheben ist, dass in allen Studien ein exzellentes Ansprechen auf eine einmalige Boosterimpfung bei fast allen Kindern beobachtet wurde [22], sodass bei entsprechendem Risikoverhalten, potenzieller HBV-Exposition und fehlendem anti-HBs-Nachweis eine Nachimpfung zu erwägen ist. Zu berücksichtigen ist weiterhin, dass der anti-HBs-Titer bei einer Immunsuppression schnell abfallen kann, wie wir beispielsweise für lebertransplantierte Patienten zeigen konnten [23]. Letztlich kann das wahre Risiko für eine akute HBV-Infektion bei Jugendlichen in Deutschland nicht determiniert werden.…”

Section: Diskussionunclassified