艾滋病合并乙型肝炎患者乙肝病毒血清学与HBV-DNA的关系  

Correlation between Serological Markers of Hepatitis B Virus and HBV-DNA in HIV/HBV Co-infected Patients

作　　者：兰青[1] 范晶华[1] 陈一晖[1] 周菊[1] 范蕊璿 李武[1] 

机构地区：[1]昆明医科大学第一附属医院感染性疾病科,云南昆明650032

出　　处：《昆明医科大学学报》2015年第4期152-156,共5页Journal of Kunming Medical University

基　　金：云南省卫生厅科技计划项目(2011WS0052);层次卫生技术人才感染疾病学科带头人资助项目(D-201219)

摘　　要：目的分析艾滋病合并乙型肝炎患者乙肝病毒血清学标志物(HBV-M)水平与HBV-DNA之间的关系.方法采用荧光定量聚合酶链反应(FQ PCR)技术和时间分辨荧光免疫法(TRFIA)检测64例HIV/HBV合并感染者的乙肝病毒血清学标志物和HBV-DNA水平.结果HBs Ag+HBe Ag+HBc Ab组和HBs Ag+HBe Ag组的HBV-DNA阳性检出率分别为70.59%和100%,显著高于其他血清学标志物模式(P<0.05),且HBe Ag阳性组中HBV-DNA阳性率也显著高于HBe Ag阴性组(P<0.05).HBs Ag含量在不同的HBV-DNA水平中总体有差异,两两比较发现在HBV-DNA<3 copies/m L组与HBV-DNA 5 copies/m L组之间有统计学差异,HBs Ag含量在高病毒复制组中显著高于HBV-DNA阴性组(P<0.05),但HBs Ag含量在HBV-DNA中低水平之间无统计学差异(P>0.05).同样,HBs Ag定量在不同HBV血清学标志物模式中总体有差异,通过两两比较,病毒复制活跃的HBs Ag+HBe Ag+HBc Ab组HBs Ag含量显著高于HBs Ag+HBe Ab+HBc Ab组(P<0.05),而其他血清学标志物模式之间没有明显的差异.经直线回归分析,HBV-DNA与HBs Ag之间存在正相关(回归系数=0.244>0),当HBs Ag>3.24 lgng/m L,即出现HBV-DNA阳性.结论HBe Ag在HIV/HBV合并感染者中可作为HBV复制活跃的标志之一,但须同时监测HBV-DNA水平,以评估病情的变化和指导临床诊疗.同样,HBs Ag含量与HBV-DNA复制水平有关,HBV复制越活跃,HBs Ag的含量也越高,二者相关性越好,但临床上单用HBs Ag定量结果来评价HIV/HBV合并感染者HBV-DNA水平有其局限性,需具体结合HBV-DNA定量值和临床综合评价患者病情和疗效.Objective To analyze the correlation between serological markers of hepatitis B virus （HBV-M） and hepatitis B virus DNA （HBV-DNA） in HIV/HBV co-infected patients. Methods In 64 patients co-infected with HIV/HBV, HBV-M was detected by time-resolved fluorescence immunoassay （TRFIA） , and HBV-DNA level was detected by fluorescence quantitative polymerase chain reaction （FQ PCR） . Results The positive rate of HBV-DNA in HBsAg＋HBeAg＋HBcAb group and HBsAg＋HBeAg group was 70.59% and 100%, respectively, which was significantly higher than that of other hepatitis B virus serological patterns （P 〈 0.05） HBV-DNA positive rate of HBeAg-positive group was also significantly higher than that of HBeAg-negative group （P 〈 0.05） . In the overall, there was a significant difference in the HBsAg content in different levels of HBV-DNA. Pairwise comparison showed that HBsAg content was significantly different between HBV-DNA〈3 copies/mL group and HBV-DNA 5 copies/mL. HBsAg level in the group of high viral replication was significantly higher than that in the HBV-DNA negative group （P 〈 0.05） , while there was no significant difference of the HBsAg content between the middle and low HBV-DNA levels （P 〉 0.05） . Similarly, the level of HBsAg was different in the overall in different hepatitis B Virus serological patterns. By pairwise comparison, it was found that the HBsAg level in HBsAg＋HBeAg＋HBcAb group was significantly higher than that of the HBsAg＋HBeAb＋HBcAb group （P 〈 0.05） , while there was no significant difference between other patterns. Through linear regression analysis, it was found that HBV-DNA existed positive correlation with HBsAg （regression coefficient = 0.244 〉0） , HBV-DNA positive appears when HBsAg 〉 3.24 gng/mL. Conclusion HBeAg indicates the activity of replication of HBV in HIV/HBV co-infected patients. However, we should detect the HBV-DNA level to assess the patient＇s condition during the clinical diagnosis and treatment. The content of HB

关 键 词：HBV-DNA HBV血清学标志物 HBSAG定量 HIV/HBV合并感染 

分 类 号：R512.62[医药卫生—内科学]