慢性乙型肝炎患者HBV基因表型与血清学测定的临床意义

摘要

目的 分析慢性乙型肝炎患者HBV基因表型和血清学特征,以探讨二者的临床意义. 方法 检测210例慢性乙型肝炎患者HBV DNA载量和HBV 基因亚型、HBV血清标志物HBsAg和HBeAg以及ALT水平,分析免疫耐受期、免疫清除期、低水平复制期和复发期4个时相中HBV基因亚型与血清标志物水平、HBsAg效价与HBV DNA载量、HBeAg及ALT水平的相关性. 结果 慢性乙型肝炎患者 HBV基因型主要为 HBV DNA 高载量的 B2 和中等载量的 C2 亚型,阳性率分别为59. 0%和25. 2%. B2亚型与HBsAg、HBeAg和ALT水平均呈显著正相关(P<0. 01),C2亚型与各指标水平均无显著相关性(P<0. 05). 乙型肝炎不同时相的基因亚型阳性率之间差异无统计学意义(P>0. 05),但HBsAg水平与HBV DNA量、HBeAg和ALT水平分别存在不同的相关性. 结论 HBV基因分型和血清学检测可早期预测慢性乙型肝炎患者长期疾病进展结果.%Objective To characterize the molecular genotypes and quantitative serological biomarker, and to explore their clinical significance in patients with chronic hepatitis B ( CHB) . Methods A total of 210 CHB patients were enrolled and HBV DNA loading, HBV molecular genotypes, quantitative serological biomarker, and ALT were measured. Patients were grouped according to the natural phases of HBV infection:HBeAg (+) immune tolerance, immune clearance, HBeAg (-) low replicative and reactivation phase. The correlation was analyzed between molecular genotypes and serological biomarkers, HBsAg and other biomarkers. Results Subgenotypes B2 with high level of HBV DNA and C2 with middle level of HBV DNA were found to be most prevalent. The positive rates were 59. 0%(B2) and 25. 2%(C2). Patients genotype with B showing more potent viral activity. Subgenotype B2 was sinificantly corelated with HB-sAg, HbeAg, and ALT levels(P < 0. 01), but there was no statistical difference for subgenotype C2. There was statistical difference be-tween positive rates of subgenotypes(P>0. 05), but HBsAg level was found to be significantly correlated with HBV DNA, HBeAg, ALT levels during some phases of CHB. Conclusion Molecular genotyping and quantitative serological biomarkers detection might be helpful for earlier prediction of the long-term disease outcomes in patients with CHB.