肝炎病毒与EB病毒重叠感染

Superinfection of Hepatitis Virus and EpsteinBarr Virus

为探讨肝炎病毒（ＨＶ）与ＥＢ病毒（ＥＢＶ）重叠感染的状况和后果，我们用免疫酶法对１５４例各型病毒性肝炎患者作了ＥＢＶＩｇＡ抗体检测。结果发现，急性肝炎、慢性轻度肝炎、慢性中度肝炎、肝炎肝硬化、慢性重型肝炎和原发性肝癌ＶＧＡ－ＩｇＡ抗体的阳性率分别为２４．０％、３０．０％、５３．３％、６３．３％、４０．０％和７２．７％，与健康人（５．３％）比较，有非常显著升高（Ｐ＜０．０１）；原发性肝癌又较急性肝炎和慢性轻度肝炎高，并有非常显著意义差异（Ｐ＜０．０１）。ＨＢＶ和ＨＡＶ＋ＨＢＶ感染者比较，前者又较后者低（Ｐ＜０．０１）。重叠感染者的临床表现均为“肝炎型”，未见咽炎、腺热、胃肠、肺炎、肾炎、神经等类型。重叠感染者的ＣＤ＋３及ＣＤ＋４Ｔ细胞下降，ＣＤ＋８Ｔ细胞及ＩｇＧ，ＩｇＭ升高，与健康人比较差异非常显著意义（Ｐ＜０．０１）。结果提示：ＨＶ感染，不仅因免疫失调易感ＥＢＶ，又可因重叠感染而进一步使免疫功能失调；对病毒性肝炎的处理应强调免疫调节治疗。

Using immune enzyme method,anti-VCA-IgA of EpsteinBarr Virus(EBV) were determined in 154 patients with various hepatitis.Results:The positive rate of anti-VCA-IgA in acute hepatitis(AH),chronic light hepatitis(CLH),chonic middle hepatitis(CMH),liver cirrhosis(LC),chonic heavy hepatitis(CHF) and primary hepatocellular carcinoma(HCC) were 24.0%,30.0%,33.3%,63.3%,40.0%,and 72.7% respectively.The positire rate of patients with various hepatitis were significantly higher than in healthy control group(5.3%,P<0.01).The percentage of patients with HCC was grater compared with AH (72.7% vs.24.0%,P<0.01) and CLH 72.7% vs.24.0%,P<0.01).The detective rate of only one hepatitis B virus infection was significantly higher than in hepatitis A+B virus superinfection (51.0% vs.24.0%,P<0.01).The clinical feature of patients with hepatitis virus(HV) and EBV superinfection were all “hepatitis type”,another type such as pharyngitis,lymphadenitis,gastroenteritis,pneumonia,nephritis,and neuropathy etc.were not find.The percentage of CD+3 T lymphocyte (45.2±4.9%) and CD+4 Tcell (30.6±3.5%) of patients with HV+EBV superinfection were significantly lower compared with healthy control group (CD3∶54.7±8.1%,CD4∶40.7±8.4%).and the CD8+T cell (36.3±5.0%),IgG(19.65±4.48g/l) and IgM (3.08±0.86g/l) of that were significantly higher than in healthy control group(29.5±8.5%,13.72±3.06g/l and 13.2±0.38g/l,P all<0.01).Conclusions:In patients with hepatitis virus infection,not only EBV superin-fection was easy due to immunodeficiency,but also immunoconfusion was furthered owing to superinfection.Immune modificatiom must be stress for tretment of VH. 