잠재감염에 의한 HBsAg 음성 B형 간염 급성 악화 1예
A Case of Acute Hepatitis B by Occult HBV Infection without HbsAg Seroconversion
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초록
근 면역억제제의 사용이 증가함에 따라 B형 잠재감염의 재활성화로 인한 간염의 빈도가 증가하고 있다. 하지만 잠재감염 자체의 임상적 의미는 거의 알려지지 않았다. 저자들은 B형 잠재감염이 재활성화 없이 간염 급성 악화를 일으킨 증례를 경험하였다. 환자는 항바이러스제의 투약 이후에 합병증 없이 회복되었다. 이 증례는 향후에 면역억제제를 사용하는 환자에서 간염이 생겼을 때 B형 잠재감염 자체도 원인이 될 수 있으며, 경우에 따라서는 이에 대한 항바이러스제의 치료를 필요하다는 것을 시사한다.
Abstract
Many studies have recently reported reactivation in hepatitis B surface antigen (HBsAg)-negative subjects with the use of biologic agents such as rituximab. However, occult hepatitis B virus infection itself has little clinical impact. We experienced a case of acute exacerbation caused by occult hepatitis B infection without HBsAg seroconversion. No mutation was found on the major hydrophilic loop of the S protein. The patient recovered from acute exacerbation after antiviral therapy. In conclusion, acute exacerbation can be induced by occult hepatitis B virus infection itself without reactivation. In such a case, antiviral therapy should be considered. (Korean J Med 2012;83:619-623)
참고문헌 (10)
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