山东省社区人群隐匿性乙型肝炎病毒感染现状分析

Analysis on Occult Hepatitis B Virus Infection Status among Community-based Population in Shandong Province,China

目的分析山东省社区人群隐匿性乙型肝炎(乙肝)病毒感染[Occult Hepatitis B Virus(HBV)Infection,OBI]的发生率和分子生物学特点。方法按照系统抽样方法,随机抽取全省乙肝血清流行病学调查中乙肝病毒表面抗原(HBV Surface Antigen,HBsAg)阴性标本,提取脱氧核糖核酸,采用套式聚合酶链反应扩增HBV的S基因和C基因,两基因均为阳性者确定为OBI;对扩增产物测序,比较和分析基因变异情况。结果共检测485份HBsAg阴性血清标本,4份检出OBI,检出率为0.82%。OBI毒株均为C基因型、adrq+血清学亚型;2例(0.41%)出现"a"抗原决定簇变异(1例为G145R突变,1例为S143T突变),2例出现"a"抗原决定簇以外突变(均为T47K突变)。结论山东省社区人群中OBI流行率较低,其检出率与HBV血清学感染标志有关;HBV基因突变可能是其发生的原因之一。

Objective To analysis the prevalence of hepatitis B Virus（HBV）infection（OBI）among community-based population in Shandong province.Methods Serum specimen negative for HBV surface antigen（HBsAg）were selected by systematic sampling from those obtained in the provincial hepatitis B serosurvey.Total deoxyribonucleic acid（DNA）was extracted from the samples and HBV S gene and C gene were amplified by nested polymerase chain reaction（nPCR）.Only those positive for both S gene and C gene were determined as OBI.The PCR products were sequenced and gene mutation was analyzed.Results 485 serum specimen were detected and 4（0.82%）of them were determined as OBI.The prevalence of OBI was significantly different among the population with different composite models of HBV seromarkers.All of these 4 HBV strains were identified with genotype C and adrq＋ serotype and 2 strains with ＂a＂ determinant mutant were detected among them.Conclusion OBI could be found in a very small proportion of the community population negative for HBsAg.The prevalence of OBI was correlated with the composite model of HBV seromarkers.HBV gene mutant might be related with OBI.