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警惕慢性乙型肝炎功能性治愈者中的隐匿性乙型肝炎病毒感染状态及其再激活风险
鲁凤民1，张晓晶2，周　召1，陈香梅1，刘寿荣2
1.北京大学医学部基础医学院病原生物学系暨感染病研究中心，北京 100191；2.浙江中医药大学附属杭州西溪医院肝病科，杭州 310023
摘要:
［摘要］　慢性乙型肝炎（CHB）的功能性治愈以血清HBsAg清除和乙型肝炎病毒（HBV）DNA持续阴性为标志，但部分患者肝组织内因仍存在共价闭合环状DNA（cccDNA）而处于隐匿性HBV感染（OBI）状态。该文在回顾分析既往的OBI与隐匿性乙型肝炎(OHB）争议基础上，探讨了获得功能性治愈的患者肝组织内cccDNA持续存在的机制。建议将功能性治愈者纳入OBI管理框架，以减少病毒再激活及输血传播等潜在风险。
关键词:  隐匿性乙型肝炎病毒感染  隐匿性乙型肝炎  功能性治愈  共价闭合环状DNA  病毒再激活
DOI：10.3969/j.issn.1674-3806.2025.07.07
分类号:
基金项目:国家重点研发计划课题（编号：2024YFC2311002）；杭州市医药卫生科技重点项目（编号：ZD20230090）
Be vigilant against occult HBV infection status and its reactivation risk in patients with functional cure of chronic hepatitis B
LU Fengmin1, ZHANG Xiaojing2, ZHOU Zhao1, CHEN Xiangmei1, LIU Shourong2
1.Department of Pathogenic Biology and Infectious Disease Research Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China; 2.Department of Hepatology, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310023, China
Abstract:
［Abstract］　Functional cure of chronic hepatitis B(CHB) is characterized by serum HBsAg clearance and persistent negativity of chronic hepatitis B virus(HBV) deoxyribonucleic acid(DNA). However, some patients are still in a state of occult HBV infection(OBI) due to the presence of covalently closed circular DNA(cccDNA) in their liver tissues. Based on a retrospective analysis of the previous disputes over the definitions of OBI and occult hepatitis B(OHB), this paper explores the mechanism of the persistence of cccDNA in the liver tissues of the patients who have achieved functional cure. It is recommended that those who have achieved functional cure be included in the OBI management framework to reduce the potential risks such as virus reactivation and infection transmission through blood transfusion.
Key words:  Occult hepatitis B virus(HBV) infection(OBI)  Occult hepatitis B(OHB)  Functional cure  Covalently closed circular DNA(cccDNA)  Virus reactivation