上饶市隐匿性乙肝病毒感染状况的研究  

Study on Occult Hepatitis B Virus Infection Status in Shangrao City

作　　者：杨丽华 王振峰 吴雅静 YANG Lihua;WANG Zhenfeng;WU Yajing(Shangrao People's Hospital,Jiangxi Province,Shangrao 334000,China;不详)

机构地区：[1]江西省上饶市人民医院,江西上饶334000

出　　处：《中国医学创新》2023年第34期90-93,共4页Medical Innovation of China

基　　金：上饶市科技局重点研发项目(2021E002)。

摘　　要：目的:探讨上饶市隐匿性乙肝病毒感染(OBI)状况,并分析其血清学指标与基因特征。方法:收集2021年6月—2022年8月上饶市居民体检血液标本72 584例,对所有血液样本进行乙肝表面抗原(HBsAg)检测,对HBsAg阴性的标本进行乙肝病毒(HBV)DNA检测。对OBI样本检测其乙型肝炎病毒表面抗体(HBsAb)、乙型肝炎E抗原(HBeAg)、乙型肝炎E抗体(HBeAb)、乙型肝炎病毒核心抗体(HBcAb)水平,以及谷丙转氨酶(ALT)和谷草转氨酶(AST)水平。同时对OBI样本进行HBV基因分型与S区氨基酸做突变检测。结果:72 584例血液标本中HBsAg阴性且HBV DNA阳性检出率为0.11%(81/72 584),OBI检出率为0.10%(74/72 584)。74例OBI患者中单独HBcAb阳性占比最高(37.84%),不同血清学特征OBI患者间ALT和AST水平差异均无统计学意义(P>0.05)。74例OBI患者实时荧光PCR检测中,74例OBI样本中有19例呈阳性,检出率为25.68%。19例HBV DNA阳性患者中有15例样本扩增出S区序列,其中HBV基因分型B型13例,C型2例,且均发生S区氨基酸发生突变,其中14例HBsAg抗原决定簇基因及周边主要亲水区域(MHR)检测出氨基酸突变。结论:上饶市居民中OBI感染率较高,其中HBcAb阳性占比最高,HBV基因分型以B型居多,S区及MHR氨基酸突变可能与OBI感染的发生密切相关。Objective:To explore the status of occult hepatitis B virus infection(OBI)in Shangrao city,and analyze the serological indicators and gene characteristics.Method:A total of 72,584 blood samples of residents with physical examination in Shangrao City were collected between June 2021 and August 2022.Hepatitis B surface antigen(HBsAg)detection was performed on all blood samples,and hepatitis B virus(HBV)DNA detection was performed on HBsAg negative samples.The levels of hepatitis B virus surface antibody(HBsAb),hepatitis B E antigen(HBeAg),hepatitis B E antibody(HBeAb),hepatitis B virus core antibody(HBcAb),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were detected among OBI samples.HBV genotyping and S region amino acid mutation detection were performed on OBI samples.Result:The detection rate of negative HBsAg with positive HBV DNA in 72,584 blood samples was 0.11%(81/72,584),and the detection rate of OBI was 0.10%(74/72,584).Among the 74 patients with OBI,positive HBcAb alone accounted for the highest proportion(37.84%),and there were no statistical differences in ALT and AST levels among OBI patients of different serological characteristics(P>0.05).A total of 74 OBI patients were detected by real-time PCR,19 out of 74 OBI samples were positive,with a detection rate of 25.68%.The S-region sequence was amplified in 15 of 19 HBV-DNA positive patients,including 13 cases of HBV genotype B and 2 cases of HBV genotype C,and S region amino acid mutation was detected in all cases.Amino acid mutations were detected in 14 cases of HBsAg antigen determinant genes and surrounding major hydrophilic regions(MHR).Conclusion:The infection rate of OBI among residents in Shangrao City is high,and the proportion of positive HBcAb is the highest,the majority of HBV genotypes are B type,the mutations of S region and MHR amino acid may be closely related to the occurrence of OBI infection.

关 键 词：隐匿性乙肝病毒感染 血清学指标 HBV基因分型 上饶市 

分 类 号：R512.62[医药卫生—内科学]