HBeAg阴性慢性乙型肝炎患者出现前C和基本核启动子联合突变的意义  

The significance of united mutations in precore and BCP of HBV in patients with HBeAg-negative hepatitis B

作　　者：雷春亮[1] 彭晓谋[2] 顾琳[2] 陈雪娟[2] 杨湛[1] 唐小平[1] 

机构地区：[1]广州市第八人民医院肝病科,510060 [2]中山大学附属第三医院传染病科

出　　处：《中华传染病杂志》2005年第1期10-14,共5页Chinese Journal of Infectious Diseases

摘　　要：目的　探讨HBeAg阴性慢性乙型肝炎患者出现前C区G1896A突变和基本核启动子(BCP)区A1762T/G1764A 双突变,以及两者的联合突变对患者血清病毒含量的影响。方法　收集240份HBeAg阴性、60份HBeAg阳性慢性乙型肝炎患者血清及40份阴性对照血清,采用竞争分化聚合酶链反应(CD PCR)检测G1896A突变及A1762T/G1764A 双突变,采用实时荧光定量聚合酶链反应(PCR)检测血清中病毒含量。结果　G1896A突变在HBeAg阴性和HBeAg阳性患者中的检出率分别为57.6%和6.7%;A1762T/G1764A双突变的检出率分别为37.9%和31.7%;其中两者联合突变在HBeAg阴性患者中的检出率为13.5%。在HBeAg阴性患者中,G1896A突变主要出现在血清病毒含量低的患者,而A1762T/G1764A 双突变与血清病毒含量无关。联合变异株主要见于重度慢性乙型肝炎患者,与血清病毒含量无关。结论　G1896A 变异株复制能力较低,而A1762T/G1764A变异株对病毒复制能力影响可能较为复杂,对HBeAg合成的影响较G1896A变异株小。联合变异株的致病力相对较强,其复制能力较单纯G1896A强,值得警惕。Objective To illustrate the relationship between the serum viral load, clinical types and the G1896A in precore, A1762T/G1764A in basal core promoter (BCP) or united mutation of them of HBV from patients with HBeAg-negative hepatitis. Methods Sera from 240 HBeAg-negative, 60 HBeAg-positive patients, and 40 negative controls were collected. Mutations of G1896A and A1762T/G1764A were detected using CD-PCR. Viral load in sera was demonstrated using real-time quantification PCR. Results The mutations of G1896A were detected in 57.6% and 6.7% in HBeAg-negative and HBeAg-positive patients respectively. The mutations of A1762T/G1764A were detected in 37.9% and 31.7% in the same patients respectively. The united mutations were detected in 13.5% of HBeAg-negative patients. G1896A was associated with low viral load, and A1762T/G1764A did not have any special relation viral load in sera from HBeAg-negative patients. The united mutations often occurred in patients with severe chronic hepatitis B, and been not related to the viral load. Conclusions The replication capability of G1896A variant decreased without HBeAg production as usual. For A1762T/G1764A variant, the situation of its replication activity was complicated. Its HBeAg production was less influenced than that of G1896A variant. The united variant might has higher pathogenicity and replication activity, and to which much attention should be paid in the future.

关 键 词：HBEAG阴性 突变 慢性乙型肝炎患者 联合 血清病毒 检出率 含量 意义 相对 目的 

分 类 号：R512.62[医药卫生—内科学]