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DOI :10.18017/iuitfd.330044   IUP :10.18017/iuitfd.330044    Tam Metin (PDF)

OKÜLT HEPATİT B VİRUS ENFEKSİYONU: MOLEKÜLER MEKANİZMALAR VE KLİNİK ÖNEMİ

Bülent Çakal

Okült Hepatitis B Virüs (HBV) infeksiyonu (OBİ) serum HBV DNA statüsü dikkate alınmaksızın mevcut serolojik testler ile HBV yüzey antijeni (HBsAg) negatif tespit edilen bireylerin karaciğerin de HBV genomunun uzun süreli persistan varlığı olarak tanımlanır. OBİ virüse ve infekte bireye ait faktörler ile çevresel faktörlerin zemininde gelişen genetik, epigenetik ve immünolojik mekanizmaların karşılıklı etkileşimi ile şekillenen, HBV infeksiyonunun doğal seyri içerisinde yer alan muhtemel safhalarından biri olarak kabul edilir. OBİ klinik açıdan; okült virüsün kan transfüzyonu, doğum, hemodiyaliz ve ortotopik karaciğer gibi organ nakli yolu ile bulaşını takiben alıcıda tipik yeni HBV infeksiyonuna neden olabilmesi, immünsüpresyon koşullarında OBİ reaktivasyonu ve takiben HBV ilişkili (akut ve fulminan hepatit) karaciğer hastalıkları, kronik karaciğer hastalıklarının (KKH) progresyonu üzerine etkisi ile özellikle hepatoselüler karsinoma (HSK) için artan bir risk faktörü olduğu yönünde hipotez uyarınca yoğun bir tartışma ve araştırma konusudur. Buna karşın gerek HBV infeksiyonunun bu özgün formuna neden olan gerekse ilişkili olduğu karaciğer hastalıklarının patogenezinde rol alan moleküler mekanizmalar henüz tam olarak aydınlatılamamıştır. Bu derlemede OBİ’nin klinik önemi, epidemiyolojik özellikleri ve laboratuar tanısına yönelik bilimsel literatürün gözden geçirilmesi amaçlanmıştır.

Anahtar Kelimeler: Hepatit B virüs; okült hepatit B virüs infeksiyonu, bulaş, reaktivasyon, kronik karaciğer hastalığı, hepatoselüler karsinoma
DOI :10.18017/iuitfd.330044   IUP :10.18017/iuitfd.330044    Tam Metin (PDF)

OCCULT HEPATITIS B VIRUS INFECTION: MOLECULAR MECHANISMS AND CLINICAL SIGNIFICANCE

Bülent Çakal

Occult Hepatitis B Virus (HBV) infection (OBI) is defined as the long-lasting persistence of HBV genomes in the hepatocytes of individuals testing negative for HBV surface antigen (HBsAg) by currently available assays and usually for serum HBV DNA. OBI is considered as the possible phase in the natural history of chronic HBV infection that the host’s immune surveillance and epigenetic mechanisms are likely involved. Clinical impact of OB is that it can be transmitted (i.e., through blood transfusion, by liver organ transplantation, hemodialysis and parturition) causing classic forms of hepatitis B in newly infected individuals. The development of an immunosuppressive status may induce OBI reactivation and development of acute and often severe hepatitis. OBI can favor the progression of liver fibrosis. Also OBİ infection has been hypothesized to be a significant risk factor contributing to the progression of chronic liver diseases (CLD) with increased risk for hepatocellular carcinoma (HCC) which may lead to an increased progression of liver diseases. Although OBI is considered a phase in the natural history of HBV, the molecular mechanisms leading to its occurrence and its contribution to HCC development are yet poorly understood. In this review, it is aimed to examine clinical importance, epidemiological aspects and laboratory diagnosis of OBI in recent literature.

Anahtar Kelimeler: Hepatitis B virüs, occult hepatitis B virus infection, transmission, reactivation, chronic liver disease, hepatocellular carcinoma

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APA

Çakal, B. (2017). OKÜLT HEPATİT B VİRUS ENFEKSİYONU: MOLEKÜLER MEKANİZMALAR VE KLİNİK ÖNEMİ. İstanbul Tıp Fakültesi Dergisi, 80(2), 71-81. https://doi.org/10.18017/iuitfd.330044


AMA

Çakal B. OKÜLT HEPATİT B VİRUS ENFEKSİYONU: MOLEKÜLER MEKANİZMALAR VE KLİNİK ÖNEMİ. İstanbul Tıp Fakültesi Dergisi. 2017;80(2):71-81. https://doi.org/10.18017/iuitfd.330044


ABNT

Çakal, B. OKÜLT HEPATİT B VİRUS ENFEKSİYONU: MOLEKÜLER MEKANİZMALAR VE KLİNİK ÖNEMİ. İstanbul Tıp Fakültesi Dergisi, [Publisher Location], v. 80, n. 2, p. 71-81, 2017.


Chicago: Author-Date Style

Çakal, Bülent,. 2017. “OKÜLT HEPATİT B VİRUS ENFEKSİYONU: MOLEKÜLER MEKANİZMALAR VE KLİNİK ÖNEMİ.” İstanbul Tıp Fakültesi Dergisi 80, no. 2: 71-81. https://doi.org/10.18017/iuitfd.330044


Chicago: Humanities Style

Çakal, Bülent,. “OKÜLT HEPATİT B VİRUS ENFEKSİYONU: MOLEKÜLER MEKANİZMALAR VE KLİNİK ÖNEMİ.” İstanbul Tıp Fakültesi Dergisi 80, no. 2 (Oct. 2024): 71-81. https://doi.org/10.18017/iuitfd.330044


Harvard: Australian Style

Çakal, B 2017, 'OKÜLT HEPATİT B VİRUS ENFEKSİYONU: MOLEKÜLER MEKANİZMALAR VE KLİNİK ÖNEMİ', İstanbul Tıp Fakültesi Dergisi, vol. 80, no. 2, pp. 71-81, viewed 19 Oct. 2024, https://doi.org/10.18017/iuitfd.330044


Harvard: Author-Date Style

Çakal, B. (2017) ‘OKÜLT HEPATİT B VİRUS ENFEKSİYONU: MOLEKÜLER MEKANİZMALAR VE KLİNİK ÖNEMİ’, İstanbul Tıp Fakültesi Dergisi, 80(2), pp. 71-81. https://doi.org/10.18017/iuitfd.330044 (19 Oct. 2024).


MLA

Çakal, Bülent,. “OKÜLT HEPATİT B VİRUS ENFEKSİYONU: MOLEKÜLER MEKANİZMALAR VE KLİNİK ÖNEMİ.” İstanbul Tıp Fakültesi Dergisi, vol. 80, no. 2, 2017, pp. 71-81. [Database Container], https://doi.org/10.18017/iuitfd.330044


Vancouver

Çakal B. OKÜLT HEPATİT B VİRUS ENFEKSİYONU: MOLEKÜLER MEKANİZMALAR VE KLİNİK ÖNEMİ. İstanbul Tıp Fakültesi Dergisi [Internet]. 19 Oct. 2024 [cited 19 Oct. 2024];80(2):71-81. Available from: https://doi.org/10.18017/iuitfd.330044 doi: 10.18017/iuitfd.330044


ISNAD

Çakal, Bülent. “OKÜLT HEPATİT B VİRUS ENFEKSİYONU: MOLEKÜLER MEKANİZMALAR VE KLİNİK ÖNEMİ”. İstanbul Tıp Fakültesi Dergisi 80/2 (Oct. 2024): 71-81. https://doi.org/10.18017/iuitfd.330044



ZAMAN ÇİZELGESİ


Gönderim31.07.2016
Kabul31.03.2017
Çevrimiçi Yayınlanma30.06.2017

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