乙型肝炎表面抗原阳性血吸虫病患者 HDV 感染的血清学及预后调查

STUDIES ON HBV AND HDV COINFECTION IN PATIENTS WITH SCHISTOSOMIASIS

用酶联免疫吸附试验（ＥＬＩＳＡ）检测１２３例乙型肝炎表面抗原（ＨＢｓＡｇ）阳性的各期血吸虫病患者及５０例ＨＢｓＡｇ阳性的非血吸虫病对照人群血清丁型肝炎病毒（ＨＤＶ）标志物，用斑点杂交检测晚期血吸虫病（晚血，ＡＳ）患者ＨＢＶ－ＤＮＡ。结果表明，ＨＢｓＡｇ阳性的晚血患者ＨＤＶ标志物（ＨＤＶ－Ｍ）检出率１４．５％，显著高于急性血吸虫病（急血）、慢性血吸虫病（慢血）患者（２．５％）及对照人群（２．０％）（Ｐ＜０．０５）。随访观察发现，ＨＢＶ／ＨＤＶ双重感染的晚血患者病死率４０％，显著高于单纯ＨＢＶ感染的晚血患者（８．５％，Ｐ＜０．０５），提示晚血患者是ＨＤＶ感染的易感人群，ＨＤＶ感染是ＨＢｓＡｇ阳性晚血患者病情加重或恶化的一个重要原因，ＨＢＶ／ＨＤＶ双重感染与晚血患者死亡密切相关。

In order to investigate the HDV infection among patients with schistosomiasis, serum HDV markers were tested in 123 HBsAg- positive patients with schistosomiasis and 50 HBsAg- carriers without schistosomiasis. HBV-DNA was tested in 69 HBsAg-positive patients with advanced schistosomiasis(AS) using Dot- blot Hybridization technique. The results showed that the positive rate of HDV markers among patients with AS(14.5%) was significantly higher than that of acute(0%), chronic schistosomiasis(2.5%) and the control group(2.0%). The death rate of patients coinfected with HBV and HDV was significantly greater than that of AS patients infected with HBV alone. The results suggested that patients with AS were at high risk of HDV infection. HBV and HDV coinfection may play a crucial role in the death of patients with AS. It is important to improve the preventive measures and therapy of viral hepatitis in the endemic area of schistosomiasis .