摘要
目的研究乙型肝炎病毒(HBV)核心基因启动子(BCP)变异与e抗原(HBeAg)及病毒载量的关系。方法(1)研究对象为176例HBV慢性感染者(轻、中、重度慢性乙型病毒性肝炎,肝炎肝硬化,慢性重型肝炎和原发性肝癌)。(2)研究方法:①采用PCR微板核酸杂交结合ELISA检测显示技术,对患者血清进行检测HBVBCP区核苷酸(nt)1762碱基A→T和1764G→A联合突变。②采用PCR结合荧光探针检测技术,检测患者血清乙型肝炎病毒脱氧核糖核酸(HBVDNA)含量。③采用ELISA检测技术,检测患者血清HBV标志物(HBsAg、HBeAg、抗-HBs、抗-HBe及抗-HBc)。结果(1)在176例HBV慢性感染者中检出HBVBCP区T1762A1764变异者73例,HBVBCP变异的阳性率为41.5%。HBVBCP变异在HBeAg阴性病例的阳性率为49.4%(44/89),显著高于HBeAg阳性病例的阳性率33.3%(29/87)(P=0.03)。(2)HBVBCP变异阳性组的HBVDNA含量显著高于HBVBCP变异阴性组的含量(P=0.000)。BCP阳性组HBVDNA含量在HBeAg阳性病例及HBeAg阴性病例中均较BCP阴性组高(P=0.000)。结论(1)HBVBCP变异可引起HBV感染者的HBeAg阴转。(2)HBVBCP变异可使HBV致病力增强,病毒复制水平提高。(3)对HBsAg阳性/HBeAg阴性患者需要进一步检测HBVDNA,以免由于基因变异导致将HBeAg阴性者误认为病毒的免疫清除或静息而延误抗病毒治疗时机。
Objective In order to investigate the relationship between hepatitis B virus （HBV） basic core promoter （BCP） mutation and serum HBeAg and HBV DNA contents in HBV infected patients. Methods （ 1 ） Project subject ： 176 patients [ Chronic hepatitis B with mild,moderate and sever;liver cirrhosis,chronic fulminant hepatitis and hepatocellular carcinoma （HCC）] with chronic hepatitis B virus infection were studied. （2） Project methods： ①The A to T mutation at nucleotide 1 762 and G to Amutation at nucleotide 1 764 were determined by the nethod of polymerase chain reaction （PC R） mienopiate hybridization ELISA in these patients. ②Serum HBV DNA of these patients were detected by fluorescence PCR. ③Serum HBV markers were determined by ELISA. Results （ 1 ） The T1762 and A1764 mutants in HBV BCP region were founded in 73 patients of hepatitib B virus-related chronic liver disease. The positive rate of HBV BCP mutants was 41.5 % （73/176）. The rate of HBV BCP mutants in negative and positive groups of HBeAg was 49.4 % （44/89） and 33.3 % （29/87） respectively （ P = 0.03 ）. （2） The quantity of HBV DNA in BCP mutant group （ 10^8. 2478 ± 0. 9826 copy/ml） was significalntly higher than that in non-mutant group （ 10^5.8876 ± 1.482 2 copy/ml） （ P = 0.000） or HBeAg- （ 10^6.282 4 ± 1.481 9 VS （ 10^5 .378 8 ± 1.333 copy./ml） copy/ml, t = 11.117, P = 0.000）. Conclusion （ 1 ） The T1762A1764 mutants in HBV BCP region could lead to the negative of HBeAg and the replication of HBV DNA. In HBV infected patients with HBsAg ＋ /HBeAg,which are often conceived to have virus immune clearance of rast of virus replieation,HBV DNA content should be tested to avoid missing the occasion of antiviral therapy.
出处
《广西医学》
CAS
2006年第10期1493-1495,共3页
Guangxi Medical Journal
基金
广西科学基金项目(桂科自0339050)
广西医疗卫生科研课题(桂卫Z2004127)
