急性乙型肝炎患者HBsAg阳性持续时间相关因素分析

张家伟; 卢锋

doi:10.3969/j.issn.1001-5256.2014.11.020

急性乙型肝炎患者HBsAg阳性持续时间相关因素分析

DOI: 10.3969/j.issn.1001-5256.2014.11.020

张家伟,
卢锋

周口市中心医院感染科

详细信息

中图分类号: R512.62
计量
- 文章访问数: 2635
- HTML全文浏览量: 13
- PDF下载量: 494
- 被引次数: 0
出版历程
- 收稿日期: 2014-02-24
- 出版日期: 2014-11-20

Factors related to duration of serum HBsAg in patients with acute hepatitis B

Department of Infectious Diseases, Zhoukou Central Hospital

摘要

摘要:
目的探讨影响急性乙型肝炎患者HBsAg转阴的因素。方法将2007年2月至2013年2月在周口市中心医院感染科就诊的106例急性乙型肝炎(AHB)患者纳入本研究,每3个月检查肝功能、乙型肝炎血清学标志物、HBV DNA,随访12个月,并应用型特异性引物nPCR法对HBV进行基因分型。计数资料组间比较采用χ2检验,计量资料组间比较用t检验。结果血清HBsAg持续阳性超过6个月或12个月者与HBsAg转阴者相比,前者入院时的ALT峰值低于后者(718±696 vs 1282±913 U/L,622±514 vs1203±924 U/L,P<0.05),而入院时HBV DNA高于后者[(6.8±1.4)vs(5.2±1.5)log10拷贝/ml,(7.3±1.6)vs(5.4±1.5)log10拷贝/ml,P<0.05];感染A基因型者6、12个月时HBsAg转阴率低于B、D型(75.0%vs 89.5%、100%,83.3%vs 97.4%、100%,P<0.05)。结论 AHB患者血清HBsAg转阴率与ALT峰值、HBV DNA、基因型等因素有关。
- 肝炎,乙型 /
- 肝炎表面抗原,乙型 /
- 基因型
Abstract:
Objective To investigate the factors related to negative conversion of HBsAg in patients with acute hepatitis B (AHB) . Methods A total of 106 AHB patients who were admitted to the Department of Infectious Diseases, Zhoukou Central Hospital from February 2007 to February 2013 were recruited. Liver function, five serological markers of HBV infection (HBsAg, HBeAg, anti- HBs, anti- HBe, and anti- HBc) , and HBV- DNA were measured every three months. All patients were followed up for 12 months. The major HBV genotypes (A through D) were determined by type-specific primer nested PCR. Categorical data were expressed as rates and compared with χ2test;continuous data were expressed as mean ± SD and analyzed by t- test. Results When just admitted to our hospital, compared with the patients with negative conversion of HBsAg, AHB patients with HBsAg persisting for more than 6 or 12 months had a significantly lower peak level of alanine aminotransferase (ALT) (718 ± 696 vs 1282 ± 913 U /L, 622 ± 514 vs 1203 ± 924 U /L, P < 0. 05) and a significantly higher level of HBV- DNA (6. 8 ± 1. 4 vs 5. 2 ± 1. 5 log10 copies /ml, 7. 3 ± 1. 6 vs 5. 4 ± 1. 5 log10 copies /ml, P < 0. 05) . The HBsAg clearance rate in patients with HBV genotype A was significantly lower than that in patients with HBV genotype B or D (75. 0% vs 89. 5% or100%, 83. 3% vs 97. 4% or 100%, P < 0. 05) . Conclusion The HBsAg clearance rate in AHB patients may be associated with HBV genotypes, peak level of ALT, and HBV- DNA.
- hepatitis B /
- hepatitis B surface antigens /
- genotype

HTML全文

参考文献(11)

[1]MAST EE, ALTER MJ, MARGOLIS HS.Strategies to prevent and control hepatitis B and C virus infections:a global perspective[J].Vaccine, 1999, 17 (13-14) :1730-1733.

[2]KURUZM Z, OZGENCO, HAVUK A, et al.Rate of chronicity and time of disappearance of HBsAg following acute hepatitis B[J].Hepatogastroenterology, 2009, 56 (90) :466-469.

[3]ZHANG H, LI YT, YIN JH, et al.Risk factors for acute hepatitis B and its progression to chronic hepatitis in Shanghai, China[J].Gut, 2008, 57 (12) :1713-1720.

[4]Chinese Society of Infectious Disease and Parasitology, Chinese Society of Hepatology.Management scheme of diagnostic and therapy criteria of viral hepatitis[J].Chin J Hepatol, 2000, 8 (6) :324-329. (in Chinese) 中华医学会传染病与寄生虫病学分会、肝病学分会.病毒性肝炎防治方案[J].中华肝脏病杂志, 2000, 8 (6) :324-329.

[5]JIN H, WANG J, ZHUANG H, et al.Evaluation of two type-specific primers PCR genotyping methods of hepatitis B virus[J].Chin J Microbiol Immunol, 2009, 29 (11) :1042-1048. (in Chinese) 金晖, 王杰, 庄辉, 等.两种型特异性引物聚合酶链反应法检测乙型肝炎病毒基因型和亚型的评价[J].中华微生物学和免疫学杂志, 2009, 29 (11) :1042-1048.

[6]COLIN JF, CAZALS-HATEM D, LORIOT MA, et al.Influence of human immunodeficiency virus infection on chronic hepatitis B in homosexual men[J].Hepatology, 1999, 29 (4) :1306-1310.

[7]BOCHAROV G, LUDEWIG B, BERTOLETTI A, et al.Underwhelming the immune response:effect of slow virus growth on CD81-T-lymphocyte responses[J].J Virol, 2004, 78 (5) :2247-2254.

[8]ITO K, YOTSUYANAGI H, YATSUHASHI H, et al.Risk factors for long-term persistence of serum hepatitis B surface antigen following acute hepatitis B virus infection in Japanese adults[J].Hepatology, 2014, 59 (1) :89-97.

[9]ZENG G, WANG Z, WEN S, et al.Geographic distribution, virologic and clinical characteristics of hepatitis B virus genotypes in China[J].J Viral Hepat, 2005, 12 (6) :609-617.

[10]NAITO H, HAYASHI S, ABE K.Rapid and specific genotyping system for hepatitis B virus corresponding to six major genotypes by PCR using type-specific primers[J].J Clin Microbiol, 2001, 39 (1) :362-364.

[11] KURBANOV F, TANAKA Y, MIZOKAMI M.Geographical and genetic diversity of the human hepatitis B virus[J].Hepatol Res, 2010, 40 (1) :14-30.

施引文献

资源附件(0)

访问统计