摘要
目的了解重庆地区乙肝病毒(HBV)血清学标志物为特殊模式的HBV感染患者病毒基因型的分布情况,分析其临床特征及自然病程。方法从1 000例HBV感染者中检测到48例乙肝病毒血清学标志物为特殊模式的患者(HBsAg与抗-HBs同时阳性,HBeAg与抗-HBe同时阳性)。采用巢式聚合酶链式反应(nPCR)对特殊模式患者的HBV进行基因分型,同时对两组特殊模式患者的临床资料和HBV感染的自然史进行分析。结果 48例乙肝病毒血清学标志物为特殊模式的HBV感染者中,36例患者HBsAg与抗-HBs同时阳性,12例患者HBeAg与抗-HBe同时阳性。HBeAg+/抗-HBe+患者组的年龄较HBsAg+/抗-HBs+患者组的小(P<0.05)。HBsAg+/抗-HBs+患者中,3例(8.3%)为B2亚型,12例(33.3%)为C2亚型,21例(58.4%)未分型;HBeAg+/抗-HBe+患者中,8例(66.7%)为B2亚型,1例(8.3%)为C2亚型,3例(25.0%)未分型,两组在HBV基因型的分布上差异具有统计学意义(χ2=17.44,P<0.05)。在HBsAg+/抗-HBs+患者中,2例(4.2%)处于免疫清除期,14例(29.2%)处于低复制期,7例(14.6%)处于再活动期。HBeAg+/抗-HBe+患者中,5例(10.4%)处于免疫清除期。两组在HBV感染的自然病程中的分布差异具有统计学意义(χ2=18.26,P<0.05)。结论重庆地区乙肝病毒血清学标志物为特殊模式的慢性HBV感染者中,HBeAg与抗-HBe同时阳性的HBV感染者中B2亚型为优势基因型;HBsAg与抗-HBs同时阳性的HBV感染者中,HBV基因型以C2亚型为主。
Objective To investigate the distribution of hepatitis B virus genotypes in patients with concurrent HBsAg and anti-HBs posifivity or HBeAg and anti-HBe positivity in Chongqing region and analyze their clinical features and the natural history of chronic HBV infection. Method Of 1 000 patients with chronic hepatitis B virus infection, 48 patients with concurrenee of hepatitis B surface or E antigens and their corresponding antibodies were detected. Clinical information and sera were collected from these 48 patients. All of them had concurrent HBsAg and anti-HBs posifivity or HBeAg and anti-HBe positivity. HBV genotypes were determined by Nested PCR. Clinical features of the patients with HBsAg ＋/anti-HBs ＋ and HBeAg ＋/anti- HBe ＋ were analyzed. Preliminary analyses of the natural history of chronic hepatitis B patients were done according to the features of the four dynamic phases. Result Of the 48 patients with chronic hepatitis B virus infection, 36 had concurrent HBsAg and anti-HBs positivity, 12 had concurrent HBeAg and anti-HBe positivity. Age in HBeAg＋/anti-HBe ＋ group was younger （P 〈 0.05）. Of the 36 eases with HBsAg ＋/anti-HBs ＋ , 3 （8.3%） were B2 subgenotypes, 12 （33.3%） were C2 subgeno- types. Genotypes of the other 21 （58.4%） were not detected. Of the 12 patients with HBeAg ＋/anti-HBe ＋ , 8 （66.7%） were subgenotypes B2, 1 （8.3%） was C2 subgenotype and 3 （25.0%） were not detected. Significant differences were found in distribution of the genotypes between the HBsAg ＋/anti-HBs ＋ and the HBeAg ~/anti-HBe ＋ group （X2 = 17.44 ,P 〈 0.05 ）. In the 36 patients with the coexistence of HBsAg and anti-HBs, 2 （4.2%） were in immune clearance phase, 14 （29.2%） were in low-replication phase and 7 （ 14.6% ） were in reactivation phase. In the 12 patients with coexistence of HBeAg and anti- HBe, 5 （ 10.4% ） were in immune clearance phase. Significant differences were found in distribution of the natural history of chronic hepatitis B between the HBsAg ＋/anti-HBs ＋ and the HBeAg＋/anti-HBe ＋ group （X2 = 18.26, P 〈 0. 05 ） Conclusion In Chongqing, Subgenotypes B2 are prevalent in hepatitis B patients with concurrent HBeAg and anti-HBe positivity, while subgenotypes C2 are predominant in hepatitis B patients with concurrent HBsAg and anti-HBs positivity.
出处
《中国微生态学杂志》
CAS
CSCD
2012年第3期246-250,共5页
Chinese Journal of Microecology
