Infecția ocultă hepatică virală B la copii: probleme importante de sănătate publică

Svetlana Liubarscaia; Tatiana Raba

Autori

Svetlana Liubarscaia IMSP Spitalul Clinic Municipal pentru Copii „V.Ignatenco“ https://orcid.org/0000-0001-6205-5611
Tatiana Raba Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“ https://orcid.org/0000-0002-3970-6495

Cuvinte cheie:

AgHBs, infecție oculta VHB, cccADN

Rezumat

Infecția ocultă cu virusul hepatitei B (VHB) are importanță clinică și este o etapă deosebită în procesul infecțios viral. În această fază, replicarea ADN-ului viral, detectabil sau nedetectabil în ser, dar prezent în ficat, chiar și la cei testați negativ pentru AgHBs, este diminuată. Materiale și metode. A fost analizată baza de date a Pub Med referitor la tema infecției oculte VHB în perioada ianuarie 2013 aprilie 2023 cu selectarea publicațiilor referitoare la această infecție la copii. Rezultate. Din cele 914 surse identificate, numai 111 abordau aspecte legate de infecția ocultă VHB la copii. În această fază particulară, ADN-ul circular închis covalent (cccADN) reprezintă o rată scăzută de replicare. A fost demonstrat că mecanismele care suprimă activitatea de replicare a VHB sunt legate de controlul imun al gazdei și de factorii epigenetici. La adulți prevalența infecției oculte VHB variază semnificativ în funcție de regiunea geografică și depinde de factorii de risc pentru infecțiile parenterale, precum și de sensibilitatea testelor utilizate pentru decelarea AgHBs și ADN-ului VHB. În ceea ce privește copiii, infecția ocultă VHB este insuficient studiată, cu o prevalență estimată între 20-54%. VHB poate fi transmis parenteral, prin transfuzie de sânge, habitual sau prin transplant de ficat. Această infecție poate duce la dezvoltarea hepatitei acute; reactivarea în cazul imunosupresiei, accelerarea progresiei hepatitei cronice spre ciroză și favorizarea dezvoltării de afecțiuni maligne. Concluzii. Infecția ocultă VHB la copii reprezintă o formă clinică a infecției cronice cu VHB, caracterizată printr-o prevalență variabilă la nivel global. Markerul diagnostic important este anti-HBcor sumar, iar testarea acestuia în cazul hepatitelor de etiologie necunoscută la copii ar putea permite identificarea infecției cronice cu VHB.

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