乙、丙型肝炎病毒重叠感染临床研究

CLINICAL STUDY ON CONCURRENT INFECTION WITH HBV AND HCV

目的了解徐州地区慢性乙型肝炎（ＣＨＢ）患者中乙型肝炎病毒（ＨＢＶ）、丙型肝炎病毒（ＨＣＶ）重叠感染情况。方法对徐州地区２４７例慢性乙型肝炎患者（ＣＨＢ）进行血清丙型肝炎抗体（抗－ＨＣＶ）及丙型肝炎病毒（ＨＢＶ、ＨＣＶ）重叠感染与单纯ＨＢＶ感染患者的临床资料进行比较。结果①徐州地区ＨＢＶ、ＨＣＶ重叠感染率为１２．９６％（３２／２４７）。②重叠感染者的年龄、血清丙氨酸氨基转移酶（ＡＬＴ）、血清胆红素（ＳＢ）及黄疸发生率与单纯ＨＢＶ感染者之间无明显差异（Ｐ＞０．０５）。③重叠感染对ＨＢＶ复制无抑制现象，而重叠感染者血清抗－ＨＢｓ检出率３４．３８％（１１／３２）明显高于单纯ＨＢＶ感染者６．５１％（１４／２１５）（Ｐ＜０．０５）。结论重叠感染在徐州地区并不少见，ＨＣＶ重叠ＨＢＶ感染后未加重患者的病情，ＨＣＶ对ＨＢＶ复制无抑制作用，但可促进部分患者ＨＢｓＡｇ向抗－ＨＢｓ的转化。

Objective To assay the serum anti-HCV and HCV RNA in 247 patients with chronic hepatitis B in Xuzhou and compare the clinical findings between patients concurrently infected with HBV and HCV and those simply infected with HBV.Results (1) The concurrent infection rate was found to be 12.96% in Xuzhou.(2) No differences in age,serum aminotransferase (ALT),serum bilirubin and jaundice rate were found between the 2 types of patients.(3) Concurrent infection with HCV did not inhibit HBV replication,but the serum anti-HBs positive rate was obviously higher than that in simple HBV-infected cases (11/32 vs 14/215 or 34.4% vs 6.5%)。Conclusions Concurrent infection with HBV and HCV was common in Xuzhou.HCV concurrent infection did not aggravate the symptoms of chronic hepatitis B patients,nor inhibited HBV replication,but enhanced the seroconversion from HBsAg to anti-HBs in a portion of the patients.