慢性HBV感染者性别及HBeAg模式与血清HBV DNA水平的关系

Association of gender and HBeAg state with HBV DNA level in patients with HBV chronic infection

目的探讨慢性HBV感染者性别、HBeAg与HBV DNA水平间的关系。方法运用荧光定量PCR检测151例从未经过保肝、降酶、免疫调节或抗病毒治疗的慢性HBV感染者的血清HBV DNA,同时运用双抗体夹心酶联免疫吸附法检测HBV血清标志物,并按性别的不同对结果进行相关性探讨。结果 HBeAg阳性组中男50例,女28例,血清HBV DNA检出率为100%;HBeAg阴性组中男59例,女14例,血清HBV DNA检出率为49.3%(36/73)。总体上,2组血清HBV DNA水平差异无统计学意义。但按HBeAg状态分组后,HBeAg阳性组中男性感染者血清HBV DNA水平明显低于女性(P<0.05);HBeAg阴性组中男女HBV DNA水平差异无统计学意义。结论 HBeAg阳性组中男性感染者血清HBV DNA水平明显低于女性,可能因为男性对HBV的免疫抑制强于女性。而HBeAg阴性组中男性感染者血清HBV DNA水平与女性无差异,可能因为男性对HBV的免疫抑制虽然强于女性,但也更易导致HBV变异及肝脏炎症活动,病毒变异导致HBeAg阴转,但是HBV复制能力反而增强,因此与女性的HBV DNA水平比较无差异。

Objective To investigate the association of gender and HBeAg state with HBV DNA level in patients with chronic HBV infection. Methods Fluorescence quantitative PCR and double antibody enzyme-linked immunosorbent assays were used to detect HBV DNA levels and HBV serum markers respectively in 151 patients with chronic HBV infection, who had never received liver-protecting, enzyme-reducing, immunosuppressive and antiviral treatment. The relationship between serum HBV DNA and HBeAg state was analyzed according to the gender. Results The detection rates of HBV DNA were 100% in HBeAg-positive group with 50 males and 28 females and 49.3% （36/73） in HBeAg-negative group with 59 males and 14 females. HBV DNA levels between the two groups was not significantly different. However, HBV DNA levels of the males were significantly lower than those of the females in HBeAg-positive group （P〈0.05）, while the difference in HBV DNA levels was not significant between the males and the females in HBeAg-negative group. Conclusions Immune suppression against HBV in male patients is more powerful than that in female patients, so HBV DNA levels of the male patients are significantly lower than those of the female patients in HBeAg positive group. Meanwhile, male patients are more likely to have HBV mutation and liver inflammation than female patients, and HBV mutation may lead to HBeAg negative conversion while higher levels of HBV replication occur, so HBV DNA levels of HBeAg- negative male patients and female patients are not significantly different.