慢性乙肝患者血清HBV-DNA和HBeAg定量的相关性分析

Correlation Between Serum HBV DNA and HBeAg Levels in Patients with Chronic Hepatitis B

目的:研究慢性乙型肝炎病毒(chronic HBV,CHB)患者血清HBV-DNA含量与e抗原定量的相关性。方法:实时荧光定量PCR(FQ-PCR)和化学发光法(CLIA)分别测定1084例CHB患者血清HBV-DNA、HBeAg含量。结果:1084例HBV患者中HBeAg阳性组和阴性组HBV-DNA检出率分别为74.2%和23.8%,平均含量分别为(4.9±1.9)log10(copies/ml)和(3.9±1.0)log10(copies/ml);HBV-DNA和HBeAg之间的kap-pa系数为0.49;HBV-DNA定量和HBeAg定量之间相关系数(r)为0.659,HBeAg阳性组HBV-DNA定量和HBeAg定量之间r为0.664;不同载量HBV-DNA组,HBeAg量相差显著,HBV-DNA载量高,HBeAg量也高。结论:HBeAg阳性模式的HBV-DNA阳性率及含量进一步证实了HBeAg确实是反映HBV复制活跃的一个可靠指标,但这并不意味HBeAg转阴病毒复制就停止,HBeAg阴性CHB患者血清中仍有部分患者存在乙肝病毒颗粒;HBV-DNA载量与HBeAg量之间有一定的相关性,但相关性一般;同时检测HBV-DNA和HBeAg量对乙肝患者HBV感染、复制、传染性的判断、治疗方案的选择和疗效判断有一定的指导意义。

Objective To study the correlation between serum HBV - DNA and HBeAg levels in patients with chronic hepatitis B （CHB）. Methods Quantitative measurement of serum HBV -DNA （with FQ -PCR） and HBeAg （with CLIA） were performed in 1084 patients with CHB. Results Among the 1084 patients, the detection rate of HBV -DNA in HBeAg positive and HBeAg nega- tive patients was 74.2% and 23.8% respectively. The average contents of HBV - DNA in these two groups of patients were 4.9 ± 1. 9 log10copies/ml and 3.9 ＋ 1.0 log10 copies/ml respectively. The kappa coefficent between HBV - DNA and HBeAg was 0.49. The correlation coefficient between quantitative HBV - DNA and HBeAg in all patients as a whole was 0.659, and for the HBeAg positive group, it was 0. 664. The HBeAg quantity was significantly different in different HBV - DNA loading groups ： higher HBV - DNA loading was associated with higher HBeAg quantity. Conclusien The high positive rate and contents of HBV - DNA in HBeAg positive patients farther confirmed that HBeAg was a reliable indicator for active HBV replication. However, HBeAg negative patients were not necessary free from virus replication as over twenty percent （23.8%） of HBeAg negative patients in this study were still positive with HBV - DNA. There were some relevences between HBV - DNA loading and quantitative HBeAg, yet the kappa coefficient was only 0. 49. Combined detection of HBV - DNA and HBeAg would be clinical most desirable.