儿童乙型肝炎血清HBV cccDNA及病毒基因型研究

摘要

目的 了解甘肃省儿童血清乙型肝炎(乙肝)病毒(HBV)共价闭合环状DNA(cccDNA)及病毒基因型情况.方法 随机选择HBV-DNA阳性124例乙肝患儿(男性84例,女性40例),其中HBV携带者65例、慢性乙肝59例(轻度31例、中度18例、重度10例),对以上患儿进行基因分型、肝功、HBV-DNA载量和血清HBV cccDNA检测.结果 中、重度慢性乙肝患儿HBV cccDNA阳性率高于携带者和轻度组(F=25.429,P＜0.01)；HBeAg阳性患儿HBV cccDNA检出率高于HBeAg阴性患儿(F=28.386,P＜0.01)；HBV cccDNA阳性组的谷丙转氨酶、谷草转氨酶、总胆红素均高于阴性组(t值分别为13.241、11.347、15.013,均P＜0.01)；124例肝炎患儿中,以C、B基因型为主,C基因型为优势,B/C混合型占一定比例,还有一些其他基因型；C基因型患儿中HBV cccDNA阳性的比例高于B基因型患儿(F=23.216,P＜0.01)；而B基因型患儿中HBVcccDNA阴性的比例高于C基因型患儿(F=26.364,P＜0.01).结论 病情越重外周血HBVcccDNA检出率越高,HBV cccDNA和基因型的检测可以较好地反映HBV复制程度和临床严重程度,对诊治乙肝具有一定的指导意义.%Objective To study the serum HBV cccDNA and genotype of hepatitis B virus in children in Gansu province.Methods 124 HBV-DNA positive children were randomly selected,with 84 males and 40 females.Among the 124 patients,65 were HBV carriers,59 were chronic hepatitis(31 mild,18 moderate and 10 severe).Genotypes of their serum HBV,liver function,HBV-DNA load and serum HBV cccDNA were detected.Results In the moderate and severe groups,HBV cccDNA positive rate was higher than that in the HBV carriers or the mild group(F=25.429,P＜0.01).The HBV cccDNA detection rate in HBeAg positive group was higher than that in the HBeAg negative group(F=28.386,P＜0.01).In the HBV cccDNA positive group,glutamic-pyruvic transaminase,glutamic-oxaloacetic transaminase,total bilirubin were higher than that in the negative group(t respectively 13.241,11.347,15.013,P＜0.01).Both C and B genotypes appeared to be the majority while C genotype was dominant in the 124 cases of children hepatitis,with the rest as B/C and some other genotypes.The positive rate of HBV cccDNA C genotype was higher than that of the genotype B(F=23.216,P＜0.01)and the negative rate of HBV cccDNA genotype was higher than that of the C genotype(F=26.364,P＜0.01).Conclusion Higher detection rate was found inthose more severe cases in the peripheral blood streams.HBV cccDNA and genotype testing might better reflect the level of HBV replication and the clinical severity of the disease,showing its guiding role in clinical diagnosis and treatment of hepatitis B.