乙型和丙型肝炎病毒重叠感染的研究

Study of superinfection of HBV and HCV

目的 为了解乙型肝炎患者重叠感染丙型肝炎病毒（ＨＣＶ） 的状况，并探讨乙型肝炎病毒（ＨＢＶ） 、ＨＣＶ 重叠感染时ＨＣＶ 对ＨＢＶ 复制的影响。方法 应用ＥＬＩＳＡ 法对７１２ 例乙型肝炎患者进行了血清抗－ ＨＣＶ 检测和乙型肝炎病毒标志检测。结果 ７１２ 例乙型肝炎患者血清抗－ ＨＣＶ阳性率为１４ ．４７ ％ ，其中重型肝炎患者血清抗－ ＨＣＶ 阳性率最高（４８ ．９８ ％ ） ，急性肝炎患者最低（３．２５ ％ ） 。在不同临床类型的乙型肝炎患者之间，血清抗－ ＨＣＶ 阳性率存在显著性差异（ Ｐ＜ ０ ．００１），显示病情越重，病程越长，血清抗－ ＨＣＶ 阳性率越高；在ＨＢＶ 和ＨＣＶ 重叠感染的患者中，血清ＨＢｓＡｇ、ＨＢｅＡｇ 和抗－ ＨＢｃＩｇＭ 阳性率低于乙型肝炎患者（ Ｐ＜ ０ ．００１ ，Ｐ＜ ０ ．００１ 和Ｐ＜０ ．０５） ，而血清抗－ ＨＢｅ 阳性率高于乙型肝炎患者（ Ｐ＜ ０ ．０１），均有显著的统计学意义。结论 乙型肝炎患者重叠感染ＨＣＶ 与病情加重和慢性化的形成有关，并使ＨＢＶ 的复制受到抑制。

Objectives To understand the situation in hepatitis B patients coinciding with HCV and to explore its influence on HCV on the replication of HBV. Methods Using ELISA,712 hepatitis B patients were tested for serum anti-HCV and markers of HBV. Results Of the 712 patients, anti- HCV positive rate was 14.47 % with the highest 48.98% in patients with severe hepatitis and the lowest 3.25% in patients with acute hepatitis. Markedly different anti-HCV positive rates ( P < 0.001 ) in patients of different clinical stages were discovered. The more severe the case with longer the course, the higher the anti-HCV positive rates. In patients with superinfection of HBV and HCV, serum HBsAg,HBeAg and anti-HBcIgM positive rates were lower than those in patients with hepatitis B (P< 0.001 ,P< 0.001 and P< 0.05 ) but the anti-HBe positive rates were higher. All the differences showed an obvious statistical significance. Conclusion Hepatitis B coinciding with HCV infection is responsible for the deterioration of the disease and towards its formation of its chronic phase as well as for the inhibition of HBV replication.