血清HBsAg阴性和HBsAg阳性慢性活动性肝炎患者肝内HBV DNA的研究

A STUDY ON HBV DNA IN PATIENTS WITH SERUM HBsAg-NEGATIVE AND POSITIVE CHRONIC ACTIVE HEPATITIS

用原位杂交法和ABG法对慢性活动性肝炎患者(以下称CAH)血清HBsAg阴性34例和阳性30例对比进行了肝内HBV DNA、HBcAg和HBsAg的检测。上述检出率在34例HBsAg阴性CAH者中分别为23.5％,23.5％和32.4％,30例HBsAg阳性者中分别为63.3％、56.7％和83.3％。结果表明,在我国,血清HBsAg阴性、HBV相关抗体阳性或阴性的CAH中,仍有少部分人肝内存在HBV DNA和HBV抗原表达,并与肝病发病机理有关。血清HBsAg阳性的CAH者中,无论血清HBeAg阳性,或抗HBe阳性、或HBeAg阴性,均有较高比例的肝内HBV DNA和HBV抗原检出。肝内HBcAg与肝内HBV DNA关系密切,可作为反映HBV活跃复制指标;肝内HBsAg则不然。

HBV DNA was detected by in situ hybridization using a biotin labelled probe and HBV antigens (including HBsAg and HBcAg) and by avdin-biotin-peroxidase complex technique in liver sections from 34 patients negative for serum HBsAg and 30 patients positive for HBsAg of chronic active hepatitis.The incidence of intrahepatic HBV DNA,HBcAg and HBsAg in 34 patients negative for serum HBsAg were 23.5%,23.5% and 32.4%,and that in 30 patients positive for serum HBsAg were 63.3%,56.7% and 83.3%,respectively.In a few patients negative for HBsAg,though positive for HBV antibody (even for anti-HBs) or negative for HBV antiboody,HBV DNA and HBV antigens could still be detected in liver tissue.In these patients who showed positive HBsAg,no matter positive for serum HBeAg,or positive for anti-HBe,or negative for HBeAg,all of them had high incidence of HBV DNA positivity in liver,which were 68.8%,60.0% and 55.5%,respectively.Intrahepatic HBcAg was associated closely with the presence of HBV DNA in hepatocytes,suggesting that it could be considered as an index to reflect HBV DNA synthesis.