HBV感染恢复期血清标志物与肝细胞HBV cccDNA检测对照

摘要

目的:了解肝组织乙肝病毒共价闭合环状脱氧核糖核酸( HBV cccDNA)与血清HBV复制指标的关系,以探索判定抗HBV的疗程终结点的观察方法.方法:既往HBV感染者、乙型肝炎肝硬化肝癌及慢性乙型肝炎(CHB)患者各13例,将血清HBV DNA、HBV-M及肝组织HBV cccDNA检测结果进行对照.结果:肝硬化肝癌及CHB患者抗-HBe阳性分别为12例和9例,血HBV DNA阳性分别为6例和8例,肝细胞HBV cccDNA均阳性；既往HBV感染13例中,HBsAg阴性,抗-HBs和/或抗HBc阳性各7和6例,有3例肝细胞中HBV cccDNA阳性.抗-HBs阳性的7例肝细胞HBV cccDNA阴性,抗-HBe阳性及抗HBs合并抗-HBe阳性者,肝细胞HBV cccDNA分别为105拷贝/ml和103拷贝/ml,与抗-HBs阳性组对照,t=4.5、4.0(P均＜0.01),差异有非常显著性意义.CHB患者核苷类治疗后全应答,肝组织HBV cccDNA仍均为阳性.结论:抗-HBs阳性HBV感染后恢复期血清,肝组织HBV cccDNA阳性比率明显低于CHB抗HBe阳性HBV DNA阴性病例.抗病毒治疗CHB的终点,应是血清抗-HBs阳性的出现.%Objective: To sdudy the relationship between liver tissue covalently closed circular DNA (cccDNA) and the serum HBV indicators in order to define the endpoint of anti-HBV treatment Methods: Serum HBV DNA, HBV-M and liver tissue cccDNA were compared in 13 cases previous hepatitis B virus infection , 13 cases of liver cirrhosis patients with hepatocel-lular carcinoma, and 13 cases of chronic hepatitis B (CHB) patients . Results: Liver cancer and patients with CHB in anti-HBe positive were 12/13 cases; 9/13 cases, serum HBV DNA positive were 6/13 cases; 8/13 cases. Their liver cells HBV cccDNA of all were tested positive. There were still three cases of liver cells HBV cccDNA tested positive in 13 cases previous hepatitis B virus infection, HBsAg negative, anti-HBs and/or anti-HBc positive in 7 and 6 cases. Hepatocytes HBV cccDNA were negative in anti-HBs positive group. The hepatocytes HBV cccDNA were 105 copies/ml and 103 copies/ml in anti-HBe positive and the anti-HBs merger of the anti-HBe positive group . There were controled with anti-HBs positive group, t = 4. 5, 4. 0 (P <0. 01) , The difference was very significant After CHB nucleoside treatment were full response, the liver tissue HBV cccDNA still were positive. Conclusion: Liver organization HBVcccDNA detected in the positive rate were significantly lower in the convalescent serum of anti-HBs positive hepatitis B virus infection than the CHB of anti-HBe positive cases of HBV DNA negative. It is sup-portted that the end of antiviral treatment of CHB is serum anti-HBs positive.