乙型肝炎重叠戊型肝炎病毒感染的临床探讨

Clinical Analysis of HBV Superinfecting with HEV

目的了解乙型肝炎病毒(HBV)重叠感染戊型肝炎病毒(HEV)对乙型肝炎病情的影响。方法对单纯HBV感染者与HBV重叠HEV感染者血清天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)、凝血酶原时间(PT)、总蛋白(TP)、白蛋白(ALB)、白蛋白/球蛋白(A/G)、HBV-DNA及临床特征进行对照分析。结果重叠感染组肝功能指标AST、ALT、TBIL、PT较单纯感染组明显增高,具有显著性差异(P<0.01);TP、ALB偏低(P<0.01);两组HBV-DNA定量结果无显著性差别(P>0.05)。重叠感染患者临床症状较严重,易伴发并发症。结论HBV重叠感染HEV容易致乙型肝炎慢性化和重症化,是乙型肝炎病情加重的重要因素。

Objective To explore the influence on the disease in patients with superinfection of hepatitis B virus （HBV） and hepatitis E virus （HEV） Methods Serum levels of aspartate aminotransferase （AST）, alannine aminotransferase （ALT） total bilirubin （TBIL）, prothrombin time （PT）, total protein （TP）, albumin（ALB）, albumin/ globulin （A/G）, and HBV-DNA, and the clinical characteristicof the patients with simple HBV infection were compared with those of patients with HBV and HEV superinfection. Results The serum levels of AST, ALT, TBIL and PT of the superinfected patients were significantly higher than those of the simple infected patients （P〈0.01）, while serum levels of TP and ALB were significantly lower （P〈0.01）. The quantitation of HBV-DNA did not show any significant difference between these two groups （P〉0.05）. The clinical symptoms of superinfected patients were more serious and complications could occur more easily. Conclusion Superinfection of HBV and HEV can cause chronic and more severe hepatitis B.