Analysis of virological characteristics in autoimmune hepatitis patients with previous hepatitis virus B infection

CHEN Xinxin; ZHANG Haiping; HUANG Chunyang; YAN Huiping

doi:10.3969/j.issn.1007-8134.2024.01.002

Abstract：Objective To investigate the virological characteristics of autoimmune hepatitis patients with previous hepatitis virus B (HBV) infection. Methods A total of 180 patients with autoimmune hepatitis ( AIH ) diagnosed in Beijing YouAn Hospital from August 2012 to August 2022 were retrospectively analyzed. The clinical characteristics and laboratory indicators were compared. The diagnosis of Occult HBV infection ( OBI ) was confirmed by nested PCR and Real-time PCR, and the virological characteristics were further studied. Results The prevalence of previous HBV infection in AIH patients was 38.89％ ( 70/180 ). The ratio of antinuclear antibody ( ANA ) ( 1∶320～1∶1000 ) in AIH patients with previous HBV infection was significantly higher than that in patients without previous HBV infection ( x2=4.210, P=0.040 ). The results of virological examination showed that OBI was present in 27.27％ ( 12/44 ) of AIH patients with previous HBV infection. The HBV genotypes of OBI patients were B, C and B/C mixed. In the reading frame of HBV S region, the amino acid mutation sites of C genotype were more than those of B genotype, and the number of amino acid mutation sites of B/C mixed infection was more than that of single genotype infection. Multiple immune escape associated mutation sites ( sT125A, sI126T, etc. ), truncated mutation sites ( sC137 ), and deleted mutation sites ( AAs 113～116 ) were found in major hydrophilic regions ( MHR ). Conclusions OBI may exist in AIH patients with previous HBV infection. The mutation of some amino acid sites in S region of HBV may be related to the cause of OBI.