慢性乙型肝炎不同模式的HBeAg-Ab与血清、唾液HBV-DNA水平之间的关系

Relationship Between Different Combination of HBeAg-Ab And Serum、Saliva HBV-DNA in Chronic Hepatitis B

目的探讨慢性乙型肝炎(CHB)不同组合模式的HBeAg、HBeAb与血清、唾液HBV-DNA之间关系及其在临床、流行病学上的意义。方法用荧光聚合酶链反应(FQ-PCR)精确定量、配对检测200例慢性乙型肝炎患者血清、唾液HBV-DNA含量;以电化学发光免疫法检测血清HBeAg、HBeAb水平。结果HBeAg(+)、HBeAb(-)模式血清、唾液HBV-DNA检出率分别为96.75%、83.22%,均值为7.02±1.31、4.92±1.44logcopies/ml,与其余模式比较均有明显差异(P<0.001)。HBeAg水平与血清、唾液HBV-DNA水平间呈明显正相关(r分别为0.48、0.40;P均<0.001);HBeAg(-)、HBeAb(+)模式中,血清、唾液HBV-DNA检出率分别为67.44%、39.53%,均值为4.84±1.89、3.51±1.29logcopies/ml。HBeAg(-)、HBeAb(-)模式中,血清HBV-DNA检出率也达到66.67%,均值为4.64±2.06log拷贝/ml。结论HBeAg(-)、HBeAb(+)CHB患者,其血清、唾液中有很高的HBV-DNA检出率,临床、流行病学上仅以HBeAg作为复制的血清学指标,来判断HBV复制和评估传染性有明显局限性,需结合HBV-DNA的检测。

Objective This study aims at analyzing the relationship between different combinations of HbeAg - Ab and serum ,saliva HBV - DNA in patients with chronic hepatitis B （CHB） and its significance on clinical and epidemiology. Methods Fluorescence quantitative PCR （FQ -PCR）, which combines PCR with fluorescence probe hybridization, was used to precisely determine HBV -DNA in serum, saliva. Serum HBeAg ,HBeAb were determined by electrical chemiluminescence immunoassay（ELC） in 200 patients with CHB. Results In HBeAg（ ＋ ） ,HBeAb（ - ） mode,the rates of detectable HBV -DNA in serum, salvia in 200 cases of C HB were 96.75% , 83.22% respectively; mean HBV - DNA concentrations were 7.02 ± 1.31 and 4.92 ± 1.44 log copies/ml; there were statistically significant differences found among the modes （P 〈 0.001 ）. A close correlation between HBeAg in serum and HBV -DNA in serum and saliva existed（ r = 0.48, 0.40;P 〈0.001 ）. In HBeAg（-） ,HBeAb（ ＋ ） mode, the rates of HBV -DNA in serum, salvia were 67.44% ,39. 53% ; the means of HBV - DNA were 4.84 ± 1.89,3.51 ± 1.29 log copies/ml. HBV - DNA （ ＋ ） rate in HBeAg（ - ） ,HBeAb（ - ） combination was 66.67% , mean HBV - DNA in serum was 4.64 ± 2.06 log copies/ml o Conclusions A high rate of detectable HBV - DNA in serum and salvia was found in HBeAg（-） ,HBeAb（ ＋ ） with CHB; indicating that HBeAg, as determinant of viral replication and infectivity, is restricted in clinical and epidemiological applications ; a combined determination of HBV - DNA must be of importance in this scenario.