Prevalence of hepatitis B virus infection and associated risk factors among adult females infected with Human Immunodeficiency Virus in Ogun State,Nigeria

Background:Hepatitis B virus(HBV)infection is prevalent in sub-Saharan Africa,including Nigeria,and is frequently observed in individuals co-infected with human immunodeficiency virus(HIV).Objective:This study aims to evaluate the prevalence of serological markers for hepatitis B virus and identify the associated risk factors among women with HIV undergoing highly active antiretroviral therapy(HAART)in Ogun State,Nigeria.Methods:Ethical approval was obtained from the Babcock University Health Research Ethics Committee(BUHREC)to recruit a total of 110 adult women infected with HIV,receiving treatment at the HIV clinics of Babcock University Teaching Hospital(BUTH)in Ilishan-Remo and General Hospital in Ijebu-Ode,both located in Ogun State,Nigeria.The participants’HIV status were confirmed using three rapid diagnostic kits:Determine(Abbott Laboratories,Tokyo,Japan),Unigold HIV(Trinity Biotech Plc Bray,Co.Wicklow,Ireland),and 1/2 Stat Pak(Abbott Laboratories,Tokyo,Japan)(Chembio Diagnostic Systems,New York,USA).Additionally,an HBV 5 in 1 Panel manufactured by Innovation Biotechnology Co.,Ltd in Beijing,China,was employed to detect HBV markers qualitatively in serum samples.Results:Out of the 110 subjects that voluntarily participated in the study,4(3.6%)tested positive for HBsAg,2(1.8%)tested positive for HBsAb,81(73.6%)tested positive for HBeAg,3(2.7%)tested positive for HBeAb,and 65(59.1%)tested positive for HBcAb.There was no significant correlation between the occurrence of HBsAg and the socio-demographic characteristics of the participants(P>0.05).Various risk factors were identified,including lack of knowledge about HBV,absence of HBV vaccination history,history of blood transfusion,organ transplant,and engaging in unprotected sex,among others.Conclusion:The findings highlight the presence of HBV infection among HIV-positive women undergoing HAART in Ogun State,Nigeria,particularly within the age groups of 18–25 years and 26–30 years.These results emphasize the necessity for continuous and targeted public health interventions among this specific population.

Positive Rate of Different Hepatitis B Virus Serological Markers in Peking Union Medical College Hospital,a General Tertiary Hospital in Beijing

Objectives To investigate the positive rate of different hepatitis B virus （HBV） serological markers, and the demographic factors related to HBV infection. Methods We enrolled all patients tested for HBV serological markers, such as HBV surface antigen （HBsAg）, HBV surface antibody （HBsAb）, hepatitis B e antigen （HBeAg）, hepatitis B e antibody （HBeAb）, HBV core antibody （HBcAb）, and HBV-DNA from July 2008 to July 2009 in Peking Union Medical College Hospital. The positive rate of each HBV serological marker was calculated according to gender, age, and department, respectively. The positive rates of HBV-DNA among patients with positive HBsAg were also analyzed. Results Among 27 409 samples included, 2681 （9.8%） were HBsAg positive. When patients were divided into 9 age groups, the age-specific positive rate of HBsAg was 1.2%, 9.6%, 12.3%, 10.9%, 10.3%, 9.7%, 8.0%, 5.8%, and 4.3%, respectively. The positive rate of HBsAg in non-surgical department, surgical department, and health examination center was 16.2%, 5.8%, and 4.7%, respectively. The positive rate of HBsAg of males （13.3%） was higher than that of females （7.3%, P=0.000）. Among the 2681 HBsAg （＋） patients, 1230 （45.9%） had HBV-DNA test, of whom 564 （45.9%） were positive. Patients with HBsAg （＋）, HBeAg （＋）, and HBcAg （＋） result usually had high positive rate of HBV-DNA results （71.8%, P=0.000）. Conclusions Among this group of patients in our hospital, the positive rate of HBsAg was relatively high. Age group of 20-29, males, and patients in non-surgical departments were factors associated with high positive rate of HBsAg.

Elevated soluble 4-1BB is associated with serum markers of hepatitis B virus in patients with chronic hepatitis B

BACKGROUND Previous studies have suggested that the costimulatory molecule 4-1BB plays pivotal roles in regulating immunity during chronic viral infection.However,up to now,there are few studies about 4-1BB in chronic hepatitis B(CHB).AIM To clarify this issue,we report our comprehensive study results on the expression levels of 4-1BB in patients with CHB.METHODS From September 2018 to June 2019,a total of 64 patients with CHB were recruited from the Department of Hepatology,The First Hospital of Jilin University.Peripheral blood samples were collected from 52 treatment-naïve and 12 entecavir-treated patients with CHB as well as 37 healthy donors(including 24 healthy adults and 13 healthy children).The levels of soluble 4-1BB(s4-1BB)in plasma were measured by ELISA.4-1BB mRNA expression in peripheral blood mononuclear cells was detected by real-time quantitative PCR.RESULTS The s4-1BB levels in the plasma of patients with CHB were significantly higher than those in healthy adults(94.390±7.393 ng/mL vs 8.875±0.914 ng/mL,P<0.001).In addition,the s4-1BB level in plasma was significantly increased in patients with a higher viral load and a disease flare up.However,there were no significant differences between treatment-naïve and entecavir-treated patients.Interestingly,among treatment-naïve patients with CHB,the levels of s4-1BB in plasma had a significant positive correlation with hepatitis B surface antigen,hepatitis B virus DNA,hepatitis B e antigen,and triglyceride levels(r=0.748,P<0.001;r=0.406,P=0.004;r=0.356,P=0.019 and r=-0.469,P=0.007,respectively).The 4-1BB mRNA expression was higher in the peripheral blood mononuclear cells of patients with CHB than in the peripheral blood mononuclear cells of healthy adults,but the difference was not statistically significant.CONCLUSION These results suggest that the levels of s4-1BB may be associated with pathogenesis of hepatitis B virus and therefore may be a promising biomarker for disease progression.

Comparative Assay of Hepatitis B and C Virus Infection Markers by Different Assay Kits^1

In order to compare sensitivity of EIA and RIA assay kits for hepatitis B and C virus (HBV and HCV, respectively) infection markers, 100 serum samples in total were collected form 50 adult women each in urban and rural areas in northeast China. The number of positive cases to the three infection markers on HBV (i.e., HBsAg +, anti HBs +, and anti HBc +) and the one on HCV (anti HCV +) were examined in two laboratories, i.e., in Laboratory A with EIA kits produced in China and in Laboratory B with RIA kits. HCV infection positivity (anti HCV +) was examined by EIA kits in both laboratories, but from different sources in and outside of China, respectively. The assay in Laboratory A gave 2 HBsAg + cases out of the 100 cases examined, whereas there were 9 positive cases in Laboratory B. In contrast, 19 cases were positive to anti HCV when examined in Laboratory A, and there were 3 cases in Laboratory B. Thus, the kits used in Laboratory A gave fewer HBsAg + and more anti HCV + cases than the kits used in Laboratory B. The prevalence of anti HBs + or anti HBc + and cases did not differ when assayed in the two laboratories with EIA and RIA kits, respectively. The agreement of positive and negative findings between the two sets of testing were 93%, 93%, 93%, 86% and 82% for HBsAg, anti HBs, anti HBc, HBV (i.e., either positive to anyone of the three markers or negative to all three markers), and anti HCV, respectively. The implication of the observation on epidemiology on HBV and HCV infection prevalence was discussed.

Hepatitis B virus genetic mutations and evolution in liver diseases

Hepatitis B virus(HBV)belongs to the genus Orthohepadnavirus of the Hepadnaviridae family and is approximately 3.2 kb in length.Owing to a lack of proofreading capacity during reverse transcription and a high replication rate,HBV exhibits as quasispecies.To detect the genetic mutations of HBV,many methods with different sensitivities and throughputs were developed.According to documentary records,HBV mutation and evolution were important vial parameters in predicting disease progression and therapeutic outcome.In this review,we separately discussed the correlation between HBV genomic mutations in four open reading frames and liver disease progression.Since some of the results were controversial from different laboratories,it remains to be seen whether functional analyses will confirm their role in modifying the course of infection.

Safety and efficacy of oral HD-03/ES given for six months in patients with chronic hepatitis B virus infection

AIM： To investigate the safety and efficacy of the formulation HD-03/ES capsules in the management of patients with chronic hepatitis B infection.METHODS： A total of 25 patients were recruited to the study and were given HD-03/ES, two capsules twice daily for six months. Clinical assessment of symptoms and signs were done using the ＂clinical observation table＂ once a month before and after the treatment. Biochemical investigations of total bilirubin, ALT, AST, serum protein for liver function tests were done every month after initiating treatment. Serum was analyzed for HBV markers for HBsAg, HBeAg and HBV DNA at baseline, 4 and 6 mo alter therapy using ELISA kits from Roche.RESULTS： After 6 mo of therapy with HD-03/ES, a significant reduction of ALT values from 66.5 ± 11.1 to 39.1 ± 5.2 （P 〈 0.01） and a significant HBsAg loss （52%, P 〈 0.001）, HBeAg loss （60%, P 〈 0.05） and HBV DNA loss （60%, P 〈 0.05） was observed. Adverse effects were mild and never warranted withdrawal of the drug.CONCLUSION： The results of this pilot study indicate that HD-03/ES might be a safe and effective treatment for chronic hepatitis B infection and a long-term multicentric comparator trial is warranted and under way.

Matrix-derived serum markers in monitoring liver fibrosis in children with chronic hepatitis B treated with interferon alpha

To evaluate prospectively 4 selected serum fibrosis markers （tenascin, hyaluronan, collagen Ⅵ, TIMP-1） before, during and 12 mo after IFN treatment of children with chronic hepatitis B. METHODS： Forty-seven consecutive patients with chronic hepatitis B （range 4-16 years, mean 8 years） underwent IFN treatment （3 MU tiw for 20 wk）. Fibrosis stage and inflammation grade were assessed in a blinded fashion before and 12 mo after end of treatment. Serum fibrosis markers were determined using automated assays.RESULTS： IFN treatment improved histological inflammation but did not change fibrosis in the whole group or in subgroups. Only hyaluronan correlated significantly with histological fibrosis（r = 0.3383, P = 0.022）. Basal fibrosis markers did not differ between responders （42.5%） and nonresponders（57.5%）. During IFN treatment only serum tenascin decreased significantly in the whole group and in nonresponders. When pretreatment values were compared to values 12 mo after therapy, TIMP-1 increased in all patients and in nonresponders, and hyaluronan decreased in all patients and in responders.CONCLUSION： Tenascin reflects hepatic fibrogenesis and inflammation which decreases during IFN treatment of children with chronic hepatitis B. TIMP-1 correlates with nonresponse and hyaluronan with histological fibrosis.

92031例癌症患者HBV血清标志物特征分析

目的了解癌症患者乙型肝炎病毒(hepatitis B virus,HBV)的感染状态和感染特点。方法回顾性分析2017年7月26日至2023年9月18日于广西医科大学附属肿瘤医院确诊的92031例癌症患者的HBV血清标志物检测结果,以肝癌、非肝癌进行分组,比较未感染(全阴或Anti-HBs阳性)、感染(除外Anti-HBs任何一项阳性)、隐性感染(occult hepatitis B virus infection,OBI;HBsAg阴性、血清或肝组织HBV DNA阳性)的占比。结果92031例癌症患者的HBV总感染率为73.75%(67876/92031),其中肝癌患者的HBV总感染率为97.65%(8922/9137),非肝癌患者的HBV总感染率为71.12%(58954/82894),肝癌组的普通感染率和OBI率均显著高于非肝癌组(均P<0.001)。肝癌组HBV血清标志物中HBsAg、HBeAg、Anti-HBe、Anti-HBc的阳性率明显高于非肝癌组(均P<0.001),但Anti-HBs的阳性率低于非肝癌组(P<0.001)。肝癌组和非肝癌组分别有20种和27种血清标志物组合模式,其中14种模式构成比在两组间差异有统计学意义(均P<0.001);两组均有7种OBI血清组合模式,其中5种模式构成比在两组间的差异有统计学意义(均P<0.05)。结论癌症患者HBV感染状态和血清学组合模式复杂,区分肝癌与非肝癌进行HBV感染统计更利于癌症患者的HBV感染评估。

Non-invasive assessment of liver fibrosis in chronic hepatitis B

The goal of this review is to provide a comprehensive picture of the role,clinical applications and future perspectives of the most widely used non-invasive techniques for the evaluation of hepatitis B virus(HBV)infection.During the past decade many non-invasive methods have been developed to reduce the need for liver biopsy in staging fibrosis and to overcome whenever possible its limitations,mainly:invasiveness,costs,low reproducibility,poor acceptance by patients.Elastographic techniques conceived to assess liver stiffness,in particular transient elastography,and the most commonly used biological markers will be assessed against their respective role and limitations in staging hepatic fibrosis.Recent evidence highlights that both liver stiffness and some bio-chemical markers correlatewith survival and major clinical end-points such as liver decompensation,development of hepatocellular carcinoma and portal hypertension.Thus the non-invasive techniques here discussed can play a major role in the management of patients with chronic HBV-related hepatitis.Given their prognostic value,transient elastography and some bio-chemical markers can be used to better categorize patients with advanced fibrosis and cirrhosis and assign them to different classes of risk for clinically relevant outcomes.Very recent data indicates that the combined measurements of liver and spleen stiffness enable the reliable prediction of portal hypertension and esophageal varices development.

Serum angiotensin-converting enzyme level for evaluating significant fibrosis in chronic hepatitis B

AIM To evaluate the diagnostic performance of angiotensinconverting enzyme(ACE)on significant liver fibrosis in patients with chronic hepatitis B(CHB). METHODS In total,100 patients with CHB who underwent liver biopsy in our hospital were enrolled,and 70 patients except for 30 patients with hypertension,fatty liver or habitual alcoholic consumption were analyzed.We compared histological liver fibrosis and serum ACE levels and evaluated the predictive potential to diagnose significant liver fibrosis by comparison with several biochemical marker-based indexes such as the aspartate aminotransferase(AST)-to-platelet ratio index(APRI),the fibrosis index based on four factors(FIB-4),the Mac-2 binding protein glycosylation isomer(M2BPGi)level and the number of platelets(Plt). RESULTS Serum ACE levels showed moderately positive correlation with liver fibrotic stages(R2=0.181).Patients with significant,advanced fibrosis and cirrhosis(F2-4)had significantly higher serum ACE levels than those with early-stage fibrosis and cirrhosis(F0-1).For significant fibrosis(≥F2),the 12.8 U/L cut-off value of ACE showed 91.7%sensitivity and 75.0%specificity.The receiver-operating characteristic(ROC)curves analysis revealed that the area under the curve(AUC)value of ACE was 0.871,which was higher than that of APRI,FIB-4,M2BPGi and Plt. CONCLUSION The serum ACE level could be a novel noninvasive,easy,accurate,and inexpensive marker of significant fibrosis stage in patients with CHB.

妊娠合并慢性乙型肝炎患者乙肝标志物、前S1抗原与HBV-DNA的关系研究

目的 研究妊娠合并慢性乙型肝炎(CHB)患者乙肝标志物、前S1抗原(Pre-S1Ag)与乙型肝炎病毒核酸(HBV-DNA)的关系。方法 选取2022年5月至2023年12月我院收治的100例妊娠合并CHB患者为研究对象,依据HBV-DNA定量测定结果将其分为阳性组与阴性组,每组50例。比较两组的乙肝标志物、Pre-S1Ag水平、肝功能指标及不良妊娠结局;分析妊娠合并CHB患者乙肝标志物、Pre-S1Ag以及各项肝功能指标与HBV-DNA的相关性。结果 阳性组的乙型肝炎表面抗原(HBsAg)、乙型肝炎e抗原(HBe Ag)、Pre-S1Ag水平均高于阴性组,乙型肝炎表面抗体(HBsAb)、乙型肝炎e抗体(HBeAb)、乙型肝炎核心抗体(HBcAb)水平低于阴性组(P<0.05)。阳性组的各项肝功能指标水平均高于阴性组(P<0.05)。阳性组的剖宫产、胎膜早破、产后出血及羊水粪染发生率均高于阴性组(P<0.05)。Pearson相关性分析结果显示,妊娠合并CHB患者HBsAg、HBe Ag、Pre-S1Ag及各项肝功能指标均与HBV-DNA呈正相关,HBsAb、HBeAb及HBcAb与HBV-DNA呈负相关(P<0.05)。结论 妊娠合并CHB患者的乙肝标志物、Pre-S1Ag以及肝功能指标均与HBV-DNA密切相关。

慢性乙型肝炎患者HBV-DNA水平与其肝功能及乙肝标志物的关系研究

目的探讨慢性乙型肝炎患者乙型肝炎病毒脱氧核糖核酸(HBV-DNA)水平与其肝功能及乙型肝炎标志物的关系。方法选取95例慢性乙型肝炎患者为观察组,同期选择95例健康人群为对照组。均进行HBV-DNA定量检测、肝功能检测、乙型肝炎标志物[乙型肝炎病毒表面抗原(HBsAg)、乙型肝炎病毒E抗原(HBeAg)、乙型肝炎病毒e抗体(HBeAb)、乙型肝炎病毒核心抗体(HBcAb)]检测。比较观察组不同乙型肝炎标志物表达患者的HBV-DNA表达水平,观察组患者HBV-DNA和HBeAg阳性率;比较两组肝功能指标。结果在95例慢性乙型肝炎患者中HBV-DNA阳性45例(47.37%)。观察组患者根据乙型肝炎标志物阳性模式划分为大三阳模式,即HBsAg(+)、HBeAg(+)、HBcAb(+),共20例,HBV-DNA阳性16例(80.00%),定量水平2.24×10^(8) IU/ml;小三阳模式,即HBsAg(+)、HBeAb(+)/HBcAb(+),共62例,HBV-DNA阳性21例(33.87%),定量水平4.18×10^(6) IU/ml;HBsAg(+)、HBeAg(+)、HBeAb(+)、HBcAb(+)模式,共10例,HBV-DNA阳性7例(70.00%),定量水平1.83×10^(7) IU/ml;HBsAg(+)、HBcAb(+)模式,共3例,HBV-DNA阳性1例(33.33%),定量水平9.48×10^(5)IU/ml。观察组不同乙型肝炎标志物表达患者的HBV-DNA阳性率比较差异具有统计学意义(P<0.05),其中大三阳和HBsAg(+)、HBeAg(+)、HBeAb(+)、HBcAb(+)模式患者的HBV-DNA阳性率、定量水平高于其他类型。在95例观察组患者中HBV-DNA阳性45例(47.37%),阴性50例(52.63%);HBeAg(+)30例(31.58%),HBeAg(-)65例(68.42%),观察组患者HBV-DNA阳性率高于HBeAg阳性率,差异有统计学意义(χ^(2)=4.957,P<0.05)。观察组患者的谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)水平均高于对照组,且观察组中随着患者的HBV-DNA定量水平提高,其AST、ALT、GGT水平持续升高,差异有统计学意义(P<0.05)。结论临床检测慢性乙型肝炎患者乙型肝炎病毒复制时检测其HBV-DNA的阳性率高于乙型肝炎标志物,且HBV-DNA定量水平与其肝功能损害相关,因而应定期开展定量检测,通过明确患者的病毒复制情况评估病情及治疗效果,辅助采取合理的治疗方案。

乙肝大小三阳状态、不同HBVDNA载量孕妇肝功能指标水平分析

目的研究探讨乙肝孕妇大三阳和小三阳状态中乙型肝炎病毒(Hepatitis B virus,HBV)DNA载量、肝功能指标、肝纤维化标志物含量及不同HBVDNA载量孕妇的肝功能水平。方法选取临清市人民医院于2020年1月—2023年1月收治的120例乙肝孕妇作为研究对象,根据乙肝两对半检测结果将其分为两组,即大三阳组(n=60)和小三阳组(n=60)。比较两组HBVDNA载量、肝功能指标、肝纤维化标志物含量及不同HBVDNA载量孕妇的肝功能指标、肝纤维化标志物含量。结果大三阳组丙氨酸转移酶水平(29.00±7.62)U/L、HBVDNA水平(5.18±1.16)×10^(4)U/mL均高于小三阳组的(26.00±2.85)U/L、(2.08±1.11)×10^(4)U/mL,差异有统计学意义(t=2.856、14.956,P均<0.05)。大三阳组的重组人几丁质酶3样蛋白1水平低于小三阳组,差异有统计学意义(P<0.05)。伴随着HBVDNA载量上升,两组患者甲胎蛋白水平随之增加,但是在同等HBADNA载量下,两组甲胎蛋白水平比较,差异无统计学意义(P>0.05)。结论开展孕前抗乙肝病毒诊疗、孕期风险系数评估,采取科学有效的干预措施,均能够有效抑制乙肝在母婴中的传播。

接种乙肝疫苗对人群HBVM模式的影响

目的 :了解乙肝疫苗接种以来 ,山东省人群中乙肝感染指标和感染模式的变化情况 ,为评价疫苗免疫预防效果 ,制订乙肝防治策略提供依据。方法 :采用多级分层整群随机抽样的方法 ,抽取全省 11个县 (市区 )的 74 19人进行了乙肝疫苗接种情况的调查 ,并用固相放射免疫法检测其乙肝血清学指标。结果 :人群乙肝疫苗接种率为 2 8.2 1%。 HBs Ag、抗- HBs总阳性率分别为 5 .0 5 %、 4 5 .2 6 % ,其中未接种组为 5 .88%、 36 .14 % ,接种组为 2 .96 %、 6 8.4 7%。两组差异均有统计学意义 (P<0 .0 1)。抗 - HBs阳性率城市均高于农村 (P<0 .0 1)。结论 :接种乙肝疫苗能有效的提高抗 - HBs阳性率 ,减少乙肝病毒感染率 ,是控制乙肝发病的有效措施。

2372例慢性无症状HBV携带者血清HBVM模式的转变规律分析

目的 观察乙型肝炎病毒 (HBV)感染者血清标记物 (HBVM)模式的转变规律。方法 对 2 372例无症状HBV携带者进行了 2～ 11年 (平均 4 14年 )血清HBVM模式的随访 ,随访期内不用任何抗病毒药。结果 最初HBVM模式为HBsAg、HBeAg、抗 HBc均阳性 (简称“大三阳”)和HBsAg、抗 HBe、抗 HBc均阳性 (简称“小三阳”)者 ,随访终点时分别有 6 2 1%和 6 7 4%保持原模式不变 ;而最初模式为“大二阳”(HBsAg、HBeAg均阳性 )、“小二阳”(HBsAg、抗 HBc均阳性 )、“单抗 HBc阳性”(单项抗 HBc阳性 ,其余 4项均阴性 )、“单HBsAg阳性”(HBsAg阳性 ,其余 4项均阴性 )者 ,随访终点时保持原模式不变的比率较低 (分别为 39 3%、32 4%、8 7%、5 6 % )。小三阳或小二阳者随访期间仍可出现病毒复制 (HBeAg阳转 )。HBsAg、HBeAg平均每年阴转率分别为 1 16 %、7 1% ,抗 HBs、抗 HBe平均每年阳转率分别为 0 6 3%、4 8% ;HBeAg阴转率明显高于HBsAg阴转率 (P <0 0 1) ;抗 HBe阳转率明显高于抗 HBs阳转率 (P <0 0 1)。在随访期出现ALT升高者 46 8例 (19 7% ) ,其中 16 0例 (6 7% )表现为急性肝炎发作。结论 慢性无症状HBV携带者长期随访中不同的血清HBVM模式可相互转换 ,并可出现肝炎活动。HBsAg自然阴转率和抗 HBs的自?

福建同安肝癌高发区原发性肝癌及消化道相关癌症与HBVM，HBV—DNA相关研究

目的通过对肝癌高发区福建（同安）原发性肝癌（PHC）及消化道相关癌症患者的乙肝病毒标志物（HBVM）与乙肝病毒脱氧核糖核酸（HBV—DNA）分析比较，探讨肝癌高发区PHC，消化道相关癌症与HBVM，HBV—DNA相关性。方法采用电化学发光（ECLI）对256例PHC患者HBVM测定，同时用荧光定量PCR对其血清的HBV～DNA定量分析（对数值）。结果肝癌高发区PHC患者HBsAg阳性率88．7％，其HBsAg，HBcAb含量与胃癌组、直肠癌组比较，两组差异无统计学显著性意义（P〉0．05）。PHC组HBsAg，HBcAb阳性率与胃癌组、直肠癌组比较，两组差异有统计学显著性意义（P〈0．01）。PHC组HBV～DNA含量与胃癌组、直肠癌组比较，差异有统计学显著性意义（P〈0．05）。HBV—DNA阳性率63．6％，PHCHBV—DNA阳性率与胃癌组、直肠癌组比较，两组差异有统计学显著性意义（P〈0．01）。结论肝癌高发区PHC患者乙肝病毒标志物具有高阳性率，HBV—DNA有较高浓度复制和较高阳性率，是肝癌高发区PHC发生的重要原因。消化道相关癌症与HBVM和HBV—DNA关系不明显。

抗结核组合药对HBVM阳性肺结核病人肝功能影响的观察

目的 观察抗结核组合药对HBVM阳性肺结核病人肝功能的影响。方法 比较HBVM阳性和阴性肺结核病人组合药治疗前后肝功能损害情况。结果 HBVM阳性病人肝损率比阴性者明显增高 (P <0 .0 1) ;其中“模式Ⅰ”与“模式Ⅱ”病人肝损率差异不显著 (P >0 .0 5) ,而“模式Ⅰ +Ⅱ”病人肝损率比“模式Ⅲ”高 (P <0 .0 5)。结论 组合药致肝功能损害 ,HBVM阳性病人比阴性多见 ,尤以“模式Ⅰ、Ⅱ”病人更易发生 ,可能与用药前肝脏病理损害严重程度有关。

两种HBVM诊断试验ELISA检测试剂盒的性能评价与比较

目的建立乙型肝炎标志物酶联定性诊断试剂盒的方法学性能评价方案和实验方法。方法利用受试者工作曲线（ROC）科学、合理的确定新创和理利两种酶联免疫定性检测试剂盒检测结果判定的截断点（阚值），同时将此实验结果与厂商提供的结果判定标准相比较，观察该两种试剂盒在不同截断点下的诊断效度、信度和诊断价值的差异。结果两种酶联免疫试剂测定HBV-M在ROC截断点下新创试剂检测HBs＆Ag，HBsAb，HBeAg诊断试验的效度、信度和诊断价值均明显优于理利试剂，而检测HBcAb则不如理利试剂，检测HBeAb两者却相似。在厂商截断点下，新创试剂检测HBV—M的效度、信度和诊断价值明显比理利试剂强。无论以A还是COI为结果判定的指标，只要阴性内对照A结果稳定，各试剂检测HBV—M的LLD的结果是基本一致的；新创试剂的LLD要比理利试剂的低；ROC曲线截断点确定的LLD比厂商提供截断点所确定的LLD要低。新创试剂检测HBv—M除阴性结果外，稳定性均比理利试剂好。两种一步夹心法酶联免疫试剂检测HBsAg，HBsAb和HBeAg的高值标本均存在钩状效应（带现象），理利试剂的钩状效应比新创试剂更明显。但两种试剂的一步免疫抑制竞争法检测HBeAb和HBcAb均无明显的钩状效应。结论酶联免疫定性检测HBV—M诊断试验的效度、信度和诊断价值的评价与比较是其试剂盒检测性能评价与产品质量比较的重要方面。诊断试验的ROC曲线是HBV—M酶联试剂截断点分析、检测性能评价、产品质量比较的重要工具，值得厂商借鉴和临床推广应用。

烹饪专业大学生HBVM阳性率调查

目的 了解接种乙肝疫苗后 ,烹饪大学生HBV感染状况 ,为乙肝防治提供科学依据。方法 应用ELISA法检测 192 4名 1999- 2 0 0 1年烹饪专业大学新生HBV感染标志物。采用改良赖氏法测肝功。结果 该人群血清HBVM总阳性率为 4 1 74 % ,男、女生阳性率分别为 4 1 90 %、 4 1 30 % ,差异无统计学意义 (P >0 0 5 )。抗 -HBs单项阳性率高达 39 71% ,男 (39 90 % )女 (39 2 0 % )相近。HBsAg或 /和抗 -HBc ,或 /和抗 -HBe,或 /和HBeAg的总阳性率仅为 1 82 %。HBsAg、HBeAg阳性率男生与女生相似 (P >0 0 5 )。结论 烹饪大学生HBVM呈现出“高免疫、低感染”的特征。对大学生定期进行健康检查 ,开展HBV感染标志的动态监测 ,加强对具有传染性检出者的随访 。

HBVpreS_1-Ag、HBV-DNA、HBVM的相关性分析及其意义

目的 探讨HBV感染者血清中HBVM、HBV DNA及HBVpreS1 Ag的相关性及其意义。 方法 采用ELISA法检测HBVM和HBVpreS1抗原 ,FQ PCR定量检测HBV DNA。结果 HBVpreS1 Ag、HBV DNA在HB sAg阳性组与阴性组及HBeAg阳性组与阴性组之间的检出率均存在差异显著性 (P <0 .0 5 ) ;HBV DNA阳性组与阴性组之间HBVpreS1 Ag的检出率存在差异显著性 (χ2 =4 9.98,P <0 .0 5 )。HBsAg与HBVpreS1 Ag、HBV DNA的符合率分别为 70 %、79%。HBeAg与HBVpreS1 Ag、HBV DNA的符合率分别为 75 %、80 %。HBV DNA与HB VpreS1 Ag的符合率为 85 %。HBsAg、HBeAg与HBVpreS1抗原、HBV DNA在HBV感染者血清中具有良好的平行关系 ,HBV DNA及HBVpreS1抗原与HBsAg、HBeAg ,HBV DNA与HBVpreS1抗原之间均高度相关 ,HBV DNA与HBVpreS1抗原之间均无差异显著性 (P >0 .0 5 )。HBVpreS1抗原、HBV DNA均较HBeAg敏感。 结论 HB VpreS1 Ag、HBV DNA是反映病毒感染、复制及传染性方面的敏感指标 ,且优于HBeAg ;应用HBVpreS1抗原、HBV DNA及HBVM同时进行联合检测 ,对HBV感染的早期诊断 ,更确切地掌握病情的发生、发展及监测疗效和预后有着极其重要的意义。