Objective To explore the correlation and clinical significance of serum hepatitis B virus large envelope protein(LH Bs) and HBV DNA copies in patients with chronic hepatitis B(CHB) treated by adefovir dipivoxil,and investigate the significance of LHBs in assessing the effect of antiviral therapy with adefovir dipivoxil. Methods 117 patients with CHB,including 49 patients positive HBeAg and 68 patients negative with HBeAg,all treated with adefovir dipivoxil 10 mg/d for 96 weeks, were enrolled. Set um LHBs and HBV M were measured by enzyme linked immunosorbent assay(ELISA) and serum HBV DNA level was quantita tively detected by real time polymerase chain reaction(RT PCR). Results 24,48,72 and 96 weeks after treatment, the negative rate of HBV DNA was not significantly different with LHBs and the levels of serum LHBs were positively correlated with the levels of HBV DNA (r=0. 827). Optical density value of LHBs and levels of HBV DNA decreased simultaneously with antivirus treatment.Positive rates of HBV DNA and LHBs were 58. 7％ (27/46)and 54.3 ％ (25/46)in 46 patients positive with HBeAg, and 48.5 ％(32/66)and 65.2％ (43/66)in 68 patients negative with HBeAg. Conclusion LHBs might be a reliable marker for estimate the rep lication of HBV in patients with hepatitis B, especially for the evaluation of viral replication and prognosis of patients negative with HBeAg.%目的 探讨阿德福韦酯(ADV)抗病毒治疗慢性乙型肝炎(CHB)过程中,患者血清中乙型肝炎病毒大蛋白(LHBs)和乙型肝炎病毒(HBV)DNA载量的相关性及临床意义,评价LHBs在ADV抗病毒治疗中的应用价值.方法 将117例CHB患者分为HBeAg阳性组49例,HBeAg阴性组68例,分别给予ADV 10 mg,口服,每日1次,治疗96周.采用ELISA法检测LHBs和HBV免疫标志物(HBV-M);采用实时荧光定量PCR法检测HBV DNA.结果 抗病毒治疗24、48、72、96周后HBV DNA和LHBs转阴率无明显差别(P>0.05),LHBs水平与HBV DNA拷贝数对数呈正相关(r=0.827);LHBs A值和HBV DNA拷贝数随抗病毒治疗时间的延长同步下降;在HBeAg阳性组46例中HBV DNA、LHBs转阳率分别为58.7%(27/46)、54.3%(25/46),两者差异无统计学意义(P>0.05);在HBeAg阴性组68例中HBV DNA、LHBs转阳率分别为48.5%(32/66)、65.2%(43/66),两者差异有统计学意义(P<0.01).结论 LHBs是判断HBV体内复制的可靠指标,尤其对判断HBeAg阴性患者体内病毒复制及预后评价具有重要价值.
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