病毒性肝炎HAV，HBV，HCV，HDV和HEV重叠感染的研究

SUPPERINFECTION OF HAV,HBV,HCV,HDV AND HEV IN PATIENTS WITH VIRAL HEPATITIS

采用ＥＬＩＳＡ法检测了１０８例乙型肝炎病毒（ＨＢＶ）感染者血清中的五种肝炎病毒──甲型（ＨＡＶ）、乙型（ＨＢＶ）、丙型（ＨＣＶ）、丁型（ＨＤＶ）和成型（ＨＥＶ）肝炎病毒的标志物，并采用ＰＣＲ技术检测了患者血清ＨＢＶＤＮＡ、ＨＣＶＲＮＡ及ＨＤＶＲＮＡ。结果五种肝炎病毒重叠感染者３５例（３２．４％），单纯ＨＢＶ感染者７３例（６７．６％）。ＨＢＶ、ＨＡＶＭ重感染率为４．６％，ＨＢＶ、ＨＣＶ二重感染率为９．２％，ＨＢＶ、ＨＤＶＭ重感染率为１４．８％，ＨＢＶ、ＨＥＶ二重感染率为１．９％，ＨＢＶ、ＨＣＶ和ＨＤＶ三重感染率为１．９％。ＨＢＶ、ＨＤＶ二重感染者发生肝硬化（ＬＣ）的频率明显高于单纯ＨＢＶ感染者（Ｐ＜０．０１）。在慢性乙肝和ＬＣ患者中，ＨＢＶ、ＨＣＶ二重感染，ＨＢＶ、ＨＢＶ二重感染和单纯ＨＢＶ感染者血清ＨＢｅＡｇ、ＨＢＶＤＮＡ阳性率之间无显著差别。上述结果提示五型肝炎病毒重叠感染情况比较严重；ＨＤＶ感染可导致肝炎慢性化、肝组织损伤加重和肝硬化的发生。ＨＣＶ和ＨＤＶ感染对ＨＢＶ复制无明显影响。

in 108 patients with HBV infection,serum anti-HAV-IgM,HBV markers,anti-HCV,HDV markers and anti-HEV-IgM were detected by ELISA method,serum HBV DNA,HCV RNAand HDV RNA were determined by polymerase chain reaction technique.In 108 patients with HBV infection,35(32.4%)were supperinfection of HAV, HBV, HCV, HDV and HEV,73(67.6%)were HBVinfection only. The supperinfection rates of HBV and HAV, HBV and HCV, HBV and HDV, HBV andHEV, HBV, HCV and HDV in patients with HBV infection were 4.6%, 9.2%,14.8%,I.9% and I.9%,respectively.The incidence of patients with liver cirrhosis was significantly higher in supperinfection ofHBV and HDV than in HBV infection only(p< 0.01).In patients with chronic hepatitis B and liverdrrhosis,the positive rates of serum HBeAg and HBV DNA had no difference among patients withsupperinfection of HBV and HCV,HBV and HDV and patients with HBV infection only.The aboveresults indicate that supperinfection rate of HAV,HBV,HCV,HDV and HEV is very high,supperinfection of HBV and HDV may lead to chronic hepatitis,severe liver tissue injury anddrrhosis;HCV and HDV may not affect HBV replication.