慢性丙型、乙型肝炎合并感染者血清标志物检测及干扰素治疗的临床观察

Clinical study on the serum markers and the effect of interferon of chronic HBV and HCV concurrent infection

目的探讨慢性丙型、乙型肝炎合并感染者体内病毒间的相互关系,以及对干扰素治疗效果的影响。方法采用ELISA法进行血清肝炎免疫检测,用荧光定量法进行丙型肝炎病毒基因(HCVRNA)和乙型肝炎病毒基因(HBVDNA)检测,并观察比较HCV、HBV合并感染与单独HCV感染者接受干扰素治疗的效果。结果HBV、HCV合并感染者血清HCVRNA和HBVDNA阳性率明显低于单独HCV、HBV感染者(46.43%和3.57%/71.43%和66.73%),且合并感染者体内HBVDNA阳性率明显低于HCVRNA(3.57%/46.43%)。HCV、HBV合并感染者接受干扰素治疗后ALT复常率、治疗结束时病毒学应答(ETVR)率,持续病毒应答(SVR)率与单独HCV感染者无明显差异(P>0.05)。结论在慢性HCV、HBV合并感染者中,体内HCV和HBV间存在相互抑制作用,且以HCV对HBV的抑制占优势。HBV的合并感染对慢性丙型肝炎干扰素治疗效果影响不大。

[Objective] To study the relationship between hepatitis virus in chronic HBV ＆ HCV concurrent infection and its influence on the effect of interferon. [Methods] 126 HCV cases, 490 HBV cases and 28 HBV＆HCV concurrent infection cases were studied. Serum hepatitis viruses, HCVRNA and HBVDNA were tested before and after interferon treatment. [Results] The positive rates of serum HCVRNA and HBVDNA were significantly lower in HCV＆HBV concurrent infection cases than in only HCV or HBV infection cases （46.43%, 3.57% vs 71.43%, 66.73%）. The positive rate was lower in HBVDNA than in HCVRNA in HBV＆HCV concurrent infection cases （3.57% vs. 46.43%）. No differences were found in ALT recovery rate, ETVR,SVR between HCV＆HBV concurrent infection cases and only HCV infection cases after interferon treatment. [Conclusions] HCV has an advantage inhibitory action to HBV in chronic HCV＆HBV concurrent infection patient. HBV co-infection has no influence on the effect of interferon in chronic HCV infection cases.