抗－HBe阳性慢性乙型肝炎病毒感染：病毒前C变异与病变活动

CHR0NIC HEPATIS B VIRUS INFECTION POSITIVE P0R ANTI-HBe:RELATIONSHIP 0F VIRAL PRE-CORE MUTATION WITH PATHOLOGICAL ACTIVITY

抗－ＨＢｅ（＋）的慢性活动性肝炎５１例，以聚合酶链反应检出ＨＢＶＤＮＡ４８例（９４．１％）。对６例以反应产物直接序列分析，发现前Ｃｎｔ８３发生Ｇ→Ａ（Ａ８３）点突变，使密码２８由ＴＧＧ变异为终止密码ＴＡＧ而不能编码ＨＢｅＡｇ。以抗－ＨＢｅ（＋）的慢性无症状ＨＢＶ携带者３０例为对照，仅１２例（４０％）检出弱ＨＢＶＤＮＡ带。５例序列分析未发现Ａ８３变异。结果提示：变异病毒逃避免疫清除而继续活跃复制，与病变持续活动有关。

of 51 cases with chronic active hepatitis positive for anti-HBe, HBV DNA wasdetected in 48(94.1%)by polymerase chain reaction(PCR).The PCR products of 6cases were directly sequenced and a G-A point mutation at nucleotide 83(A83)wasfound, which made the codon 28 mutated from TGG to TGA, a stop codon, and hence,HBeAg could not be encoded. As control,30 cases of chronic asymptomatic HBV carrierspositive for anti-HBe were also tested with PCR and HBV DNA of weak band Wasdetected only in l2(40%).The PCR products of 5 cases were sequenced in the sameway, but A83 pre-core mutation was not foul1d. The results suggested that the viralmutants could escape from immune clearance and continue to replicate actively,There-fore,pre-core mutation might be related to the chronic pathological activity.