Occult HBV infection in autoimmune hepatitis and its influence on disease progression
10.3969/j.issn.1001-5256.2022.12.011
- VernacularTitle:自身免疫性肝炎中隐匿性HBV感染的情况及其对疾病进展的影响
- Author:
Xinxin CHEN
1
;
Haiping ZHANG
2
;
Chunyang HUANG
2
;
Jianrong SU
3
;
Huiping YAN
2
Author Information
1. Center of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;Center of Clinical Laboratory, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
2. Center of Clinical Laboratory, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
3. Center of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
- Publication Type:Original Articles_Autoimmune Liver Diseases
- Keywords:
Hepatitis, Autoimmune;
Hepatitis B virus;
Infection
- From:
Journal of Clinical Hepatology
2022;38(12):2738-2743
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the prevalence rate of occult HBV infection (OBI) in patients with autoimmune hepatitis (AIH) and the influence of OBI in the clinical condition and prognosis of AIH patients. Methods A total of 103 patients with a confirmed diagnosis of AIH who were admitted to Beijing YouAn Hospital from April 2012 to March 2019 were enrolled. Nested PCR and real-time PCR were used to confirm the diagnosis of OBI, and real-time PCR was used to measure HBV pgRNA. Clinical features, laboratory markers, and follow-up analysis of prognosis were compared between the OBI group with 24 patients and the non-OBI group with 79 patients. The independent samples t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves, and the Cox regression model was used to perform univariate and multivariate analyses. Hazard ratio and its 95% confidence interval were calculated. Results The detection rate of OBI was 23.30% (24/103) in AIH patients, with an HBV DNA viral load of < 200 IU/mL, among whom 9 patients with OBI (9/24, 37.50%) were found to have HBV pgRNA in serum. Compared with the non-OBI group, the OBI group had a significantly higher positive rate of the three antibodies anti-HBs, anti-HBc, and anti-HBe ( χ 2 =5.906, P =0.016). The univariate analysis showed that OBI, hypoproteinemia, splenomegaly, and ascites were risk factors for adverse events in AIH (all P < 0.05) and were associated with disease progression, and the multivariate Cox regression analysis showed that hypoproteinemia and ascites were independent risk factors for adverse events (all P < 0.05). Conclusion There is a relatively high detection rate of OBI in AIH patients, and the presence of OBI may accelerate the progression of AIH.
