输血传播病毒(TTV)与乙型肝炎病毒混合感染的研究

The Study of Patients with HBV Infection and Virus of TTV Co-infection

目的 探讨输血传播病毒 (TTV)与HBV混合感染的情况及其对肝脏病变程度和对HBV复制的影响 .方法 应用微板核酸杂交—ELISA法检测 152例HBV患者血清中的TTVDNA和ELISA进行乙型肝炎相关病毒标志物检测 .结果 152例HBV患者中TTV -DNA阳性 2 3例 (15.1% ) ,其中无症状携带者、慢性肝炎、活动性肝硬化、原发性肝癌患者中的TTV -DNA检出率分别为 2 / 18(11.1% )、8/ 54(14 .8% )、6/ 4 0 (15.0 % )、7/ 3 8(18.4% ) ,各组间无差异 .在慢性肝炎、活动性肝硬化、原发性肝癌患者中 ,TTV -DNA阳性组与TTV -DNA阴性组各项肝功能指标改变相似 .HBV和TTV混合感染组中HBeAg和抗 -HBcIgM阳性率低于单纯HBV感染组 (p <0 .0 5) ,而血清抗 -HBe阳性率则高于单纯HBV感染组 .结论 TTV的混合感染似乎并不影响HBV所致的肝脏病变程度 。

Objective To find out the influence of patients with HBV infection and transfusion-transmitted virus (TTV) co-infection on their clinical outcome and the replication of HBV infection. Methods TTV-DNA was test by Microplate Sandwich Hybridization-ELISA technique and markers of HBV was test by ELISA in 152 patients with hepatitis B virus infection, and the results and clinical data were analyzed statistcally. Results TTV-DNA was found in 23 of the 152 (15.13%) patients. Among them, 2/18(11.1%) asymptotic carriers(ASC), 8/54(14.8%) patients with chronic hepatitis B(CHB), 6/40(15.0%) patients with active liver cirrhosis(ALC), and 7/38(18.4) patients with hepatocarcinoma(HCC) were TTV DNA positive, but there was no statistical difference among the four groups of ACS、CHB、ALC and HCC. The liver function test showed no significant different between group of simple HBV infected and group of co-infection with HBV and TTV. In patients with co-infection of HBV and TTV, the positive rates of HBeAg and anti-HBcIgM in serum were lower than those in patients with simple HBV infection( p<0.01 and p<0.05 respectively) but the positive rate of anti-HBe was significantly higher as compared with the patients of simple HBV infection ( p<0.01) . Conclusions The results showed that TTV co-infection could not affect the clinical outcome of patients, but may play the role in the inhibition of HBV replication.