慢性乙型肝炎病毒感染者HBsAg和抗-HBs共存的不同血清学模式及其意义分析

Implications of different serological patterns of HBsAg and anti-HBs coexistence in patients with chronic hepatitis B

目的探讨慢性HBV感染者HBsAg和抗-HBs共存的不同血清学模式及其意义。方法在3042例慢性HBV感染者中筛选出HBsAg和抗-HBs共存患者93例,分析其临床特征、HBsAg和抗-HBs相对滴度模式、HBeAg状态和HBV DNA水平。结果根据HBsAg和抗-HBs水平的高(H)或低(L),将HBsAg+/抗-HBs+血清学模式分为H/L、H/H、L/L和L/H四型,分别占43.0%、14.0%、35.5%和7.5%;其HBeAg+比例依次为H/L(55.0%)>H/H(38.5%)>L/L(18.2%)>L/H(14.3%);H/L与L/L型患者HBV DNA水平之间差别显著(P=0.016),而在H/L与H/H(P=0.569)以及H/H与L/L之间(P=0.095)均无显著性差别。结论在HBsAg和抗-HBs共存患者,HBsAg水平越低和抗-HBs水平越高,则HBeAg阳性率和HBV DNA水平越低。

Objective To investigate the serological patterns of HBsAg and anti-HBs coexistence in patitents with chronic hepatitis B.Methods 93 patients with HBsAg and anti-HBs coexistence were selected from 3042 patients with chronic HBV infection,and their clinical,serological and virological features were analyzed.Results Serological patterns of HBsAg and anti-HBs coexistence were devided into four types according to the levels of HBsAg and anti-HBs,i.e.,high（H）/low（L）,H/H,L/L and L/H,which accounted for 43.0%,14.0%,35.5% and 7.5%,respectively;the positive percentages of HBeAg in patients with the four serological patterns were 55.0% in H/L,38.5% in H/H,18.2% in L/L and 14.3% in L/H group;there was a significant difference for the HBV DNA levels as compared between H/L and L/L group（P=0.016）,but not between H/L and H/H group（P=0.569）or H/H and L/L group（P=0.095）.Conclusion The lower serum HBsAg level combined with higher anti-HBs level were accompanied with lower rates of HBeAg positivity and lower HBV DNA level in patients with HBsAg and anti-HBs coexistence.