乙型肝炎病毒标志物与病毒载量的关系

Relationship between the models of serologic markers and the quantities of virus in patients infected with hepatitis B virus

目的:探讨乙型肝炎病毒标志物(HBV-M)与HBV载量(HBV-DNA)的关系,为临床正确诊治乙型肝炎提供科学依据。方法:采用免疫发光和荧光定量聚合酶链反应技术分别检测了670例患者血清中的HBV-M和HBV-DNA。结果:HBeAg阳性模式HBV-DNA>5.0×104 cps/mL占96.3％(363/377),HBeAg阴性模式HBV-DNA>5.0×104 cps/mL占74.8％(160/214)。HBeAg阳性模式HBV-DNA载量显著高于HBeAg阴性模式(p<0.05)。1,3,5模式HBV-DNA载量显著高于1,4,5模式(P<0.01)。HBsAg阴性的模式中:14例HBV-DNA>5.0×104 cps/mL占18.8％(12/64),抗-HBs阳性模式中,HBV-DNA>5.0×104 cps/mL占16.7％(7/42)。结论:HBeAg阳性模式HBV-DNA载量显著高于HBeAg阴性模式。但少数HBeAg阳性模式中病毒水平很低及HBeAg阴性模式病毒水平很高。还存在着HBsAg阴性或/及抗-HBs阳性的HBV感染。故临床上只有将HBV-M与HBV载量检测相结合,才能正确判断病情及预后。

Objective: To understand the relationship between the models of serologic markers and the quantities of hepatitis B virus (HBV). Methods: The serologic markers of HBV in 670 patients were detected by using the enzyme immunoassay and the quantities of HBV in those were measured by using the real-time fluorescent quantitative PCR. Results: The HBeAg-positive patients whose copies were more than 5.0×104 cps /mL accounted for 96.3%,and the HBeAg-negative patients whose copies were more than 5.0×104 cps/mL accounted for 74.8%.The HBV copies of HBeAg-positive patients were significantly higher than HBeAg-negative patients(P<0.05). The HBV copies of anti-HBe-positive patients were significantly less than anti-HBe-negative patients(P<0.01).The HBV-DNA was detected in some HBsAg-negative (anti-HBs-positive or not) patients.Conclusion:: The HBV copies of HBeAg-positive patients are significantly higher than HBeAg-negative patients. However, some HBeAg-positive patients' HBV copies are very low,and some HBeAg-negative patients' HBV copies are very high.The HBV-DNA could be even detected in some HBsAg-negative (anti-HBs-positive or not) patients.It is helpful to judge accurately prognosis by testing the serologic marker and the quantities of virus.