Clinical study of HBsAg negative patients with chronic hepatitis B and C super-infection
摘要: 为探讨HBsAg阴性的慢性乙型重叠丙型肝炎患者HBV -DNA水平及临床特征 ,采用PCR -微板核酸杂交 -ELISA法对 2 0 3例HBVM一项 /一项以上阳性的慢性丙型肝炎患者进行HBV -DNA定量及HCV -RNA基因分型检测 ,并分析患者性别、年龄以及肝功能等临床特征。HBsAg阴性及HBsAg阳性慢性丙型肝炎患者在性别、年龄分布上无差异 ;但血清ALT及总胆红素水平在HBsAg阳性者较高。Ⅱ / 1b型HCV感染在HBsAg阴性者中的比例高于HBsAg阳性者 （P <0 0 5 ）。HBsAg阴性慢性丙肝患者HBV -DNA阳性率及HBV水平均低于HBsAg阳性患者。HBsAg阴性的慢性丙肝患者中 ,抗HBc单独阳性者HBV -DNA阳性率最高 ,但HBV -DNA水平无显著性差异。Ⅱ /1b型HCV感染在HBV -DNA阴性患者中的出现频率较高 ,与HBV -DNA阳性患者相比差异有显著性。因此 ,临床上对于那些肝功能损害严重 ,同时有抗HBc阳性或Ⅱ / 1b型HCV感染 ,尤其是HCV -RNA阴性而肝功能仍有持续损害的患者要及时行HBV -DNA检测 ,...Abstract: To study HBV-DNA levels and clinical features of HBsAg negative patients with chronic hepatitis Band C super-infection, sandwich hybidization on microplate assays were used to detect HBV quantification and HCV genotypes of 203 HBVM positive patients with chronic hepatitis C, and the clinical features of these patients were analyzed. Results showed that there was no difference between HBsAg negative and positive patients in the distribution of sex and ages, but the levels of ALT and TBil were higher in those HBsAg positive patients (P<0.05) . Infection rate of HCV Ⅱ/1b was higher in HBsAg negative patients (P<0.05) . Positive rates and the quantification of HBV-DNA in HBsAg negative patients were lower than those HBsAg positive patients. In HBsAg negative patients, positive rates of HBV-DNA in those only anti-HBc positive was the highest, but there was no difference in the quantification of HBV-DNA among them. Infection rate of HCV Ⅱ/1b was higher in HBV-DNA negative patients, it showed significant difference when compared with HBV-DNA positive patients.In conclusion, those patients with serious liver injury, anti-HBc positive or infected with HCV Ⅱ/1b, should be pay more attention, especially HCV-RNA negative with continuous liver injury, HBV-DNA shoule be detected in time even if HBsAg negative.
- chronic hepatitis C /
- hepatitis B virus /
 Harz S Conjeevaram, Anna S Lok. Occult hepatitis B virus infection: A hidden manace?[J].Hepatology, 2001, 34 (1) ∶204-206.  Sagnelli E, Coppola N, Scolastico C, et al. HCV genotype and “silent” HBV coinfection: two main risk factors for a more severe liver disease[J]. J Med Virol, 2001, 64 (3) ∶350-5.  Christian B, Valerie. Persistent hepatitis B virus infection in subjects without hepatitis B surface antigen: Clinically significant or purely “occult”?[J].Hepatology, 2001, 34 (1) 194-203.  Zhangyongyuan. Hepatitis B virus DNA in serum and liver is commonly found in chinese patients with chronic liver disease despite the presence of antibodies to HBsAg[J].Hepatology, 1993, 17∶538.  Lili Kazemi-Shirazi, Dagmar Petermann. Hepatitis B virus DNA in sera and liver tissue of HBsAg negative patients with chronic hepatitis C[J].Journal of hepatology, 2000, 33∶785-790. Liaw YF, Lin SM, Sheen IS, et al. Acute hepatitis C virus superinfection followed by spontaneous HBeAg seroconversion and HBsAg elimination[J].Infection, 1991, 19∶250-251.
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