多种肝脏疾病中隐匿性HBV感染检出率及其S基因MHR免疫逃逸相关突变特点分析  

Analysis for the detection rate of occult HBV infection and the characteristics of HBV S-gene MHR immune escape-associated mutations in patients with different liver diseases

作　　者：王钧[1] 廖昊 刘璐洁 陈容娟 罗丹 思兰兰 黄碧霞 刘妍 徐东平 WANG Jun;LIAO Hao;LIU Lu-jie;CHEN Rong-juan;LUO Dan;SI Lan-lan;HUANG Bi-xia;LIU Yan;XU Dong-ping(Peking University 302 Clinical Medical School,100039,China)

机构地区：[1]北京大学三〇二临床医学院,100039 [2]中国人民解放军总医院第五医学中心临床研究管理中心,北京100039

出　　处：《传染病信息》2020年第2期132-135,共4页Infectious Disease Information

基　　金：北京市自然科学基金(7172206);国家自然科学基金(81572010,81721002);首都卫生发展科研专项项目(2016-2-5032)。

摘　　要：目的分析多种肝脏疾病中隐匿性HBV感染(occult HBV infection,OBI)检出率,并探讨OBI患者HBV S基因主要亲水区(major hydrophilic region,MHR)免疫逃逸相关突变特点。方法回顾性分析2005年1月—2017年12月就诊于中国人民解放军总医院第五医学中心的91037例HBV感染住院患者临床资料,筛选出OBI患者并扩增其HBV S基因序列,分析其HBV S基因MHR免疫逃逸相关突变特点。结果91037例住院患者中OBI总检出率为0.53%(487/91037),急性乙型肝炎患者中OBI检出率最高(9.26%,130/1404),肝硬化患者中OBI检出率最低(0.26%,78/29921)。62例OBI患者组与124例非OBI患者组相比,OBI患者组MHR免疫逃逸相关突变总体检出率显著高于非OBI患者组(59.68%vs.35.48%;P<0.05);OBI患者组MHR多个免疫逃逸相关突变的联合检出率显著高于非OBI患者组(43.55%vs.22.58%;P<0.05);其中,sT118K、sK122R和sV168A 3种单点突变的检出率显著高于非OBI患者组。结论本研究显示临床HBV感染患者中有较高的OBI检出率,而且不同肝脏疾病中OBI检出率不同。此外,HBV S基因MHR的免疫逃逸相关突变与临床实践中OBI的发生密切相关。Objective To analyze the detection rate of occult HBV infection(OBI)in patients with different liver diseases,and explore the characteristics for HBV S-gene major hydrophilic region(MHR)immune escape-associated mutations.Methods Clinical information of 91037 inpatients with HBV infection who were admitted to the Fifth Medical Center of Chinese PLA General Hospital from January 2005 to December 2017 was retrospectively analyzed,OBI patients were screened out and their HBV S-gene sequence was amplified.The characteristics of HBV S-gene MHR immune escape-associated mutations were analyzed.Results Among the 91037 inpatients,the detection rate of OBI was 0.53%(487/91037).The detection rate of OBI was the highest in acute hepatitis B(9.26%,130/1404)and the lowest in liver cirrhosis(0.26%,78/29921).The overall detection rate of MHR immune escape-associated mutations in OBI patients group(n=62)was significantly higher than that in control group(n=124)(59.68%vs.35.48%;P<0.05).The combined detection rate of MHR multiple immune escape-associated mutations in OBI patients group was significantly higher than that in control group(43.55%vs.22.58%;P<0.05).Specifically,the detection rates of 3 single-point mutations(sT118K,sK122R,sV168A)were significantly higher in OBI patients group than those in control group.Conclusions In this study,the OBI detection rate is relatively high in clinical patients with HBV infection and the prevalence in different liver diseases varies.Additionally,the immune escapeassociated mutations of HBV S-gene MHR is closely related to the occurrence of OBI in clinical practice.

关 键 词：隐匿性HBV感染 病毒突变 主要亲水区 免疫逃逸 

分 类 号：R512.6[医药卫生—内科学]