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    Occult hepatitis B and HIV infection

    Autor: 
    Soriano, Vicente
    ;
    Aguilera, Antonio
    ;
    González, Rocío
    ;
    Gómez-Gallego, Felix
    ;
    Barea, Luisa
    ;
    Treviño, Mercedes
    ;
    Corral, Octavio Jorge
    Fecha: 
    11/2019
    Palabra clave: 
    antiretroviral drugs; hepatitis B; HIV; immune deficiency; liver; occult B infection; occult hepatitis B; pre-exposure prophylaxis; tenofovir; JCR; Scopus
    Revista / editorial: 
    European Journal of Gastroenterology & Hepatology
    Tipo de Ítem: 
    Articulo Revista Indexada
    URI: 
    https://reunir.unir.net/handle/123456789/9989
    DOI: 
    https://dx.doi.org/10.1097/MEG.0000000000001417
    Dirección web: 
    https://journals.lww.com/eurojgh/Abstract/2019/11000/Occult_hepatitis_B_and_HIV_infection.16.aspx
    Resumen:
    Introduction Occult hepatitis B virus (HBV) infection, so-called occult B infection (OBI), is defined by the recognition of HBV-DNA in the absence of serum hepatitis B surface antigen (HBsAg). The HBV-DNA genome in OBI is fully replication competent and produced in the liver, characteristically with low-level HBV-DNA fluctuations in the bloodstream. The OBI status remains between chronic (HBsAg +) and resolved (anti-HBs +) phases in the natural history of HBV infection. Methods The clinical interest in OBI has increased because of its potential for overt HBV reactivation under immunosuppression as well as for HBV transmission, well established in recipients of blood transfusions and/or organ transplants. Results Given the shared transmission routes for HIV and HBV, earlier reports claimed that OBI was more frequent in AIDS patients. By contrast, the current scenario shows that OBI is negligible in the HIV population. One explanation is that HBV immunization and recall vaccination campaigns have been very active in this group. A second and most important reason points to the wide use of antiretroviral regimens that include anti-HBV active agents, that is, tenofovir, lamivudine, and/or emtricitabine. They are recommended either as treatment for all HIV carriers or as pre-exposure prophylaxis for uninfected individuals at risk. The consequences are that HBV reactivations associated with HIV-related immunodeficiency have become very rare. Furthermore, HBV suppression with these antivirals has markedly reduced the likelihood of transmission from OBI carriers and/or acquisition by uninfected exposed individuals. Conclusion Enthusiasm unabated, however, new tenofovir-sparing antiretroviral regimens are becoming popular and might account for a resurgence of OBI in the HIV setting.
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