慢性乙型肝炎病毒感染者HBsAg和抗-HBs共存的不同血清学模式及其意义分析

摘要

Objective To investigate the serological patterns of HBsAg and anti-HBs coexistence in patitents with chronic hepatitis B. Methods 93 patients with HBsAg and anti-HBs coexistence were selected from 3042 patients with chronic HBV infection,and their clinical,serological and virological features were analyzed.Results Serological patterns of HBsAg and anti-HBs coexistence were devided into four types according to the levels of HBsAg and anti-HBs,i.e.,high (H)/low (L) , H/H, UL and UH,which accounted for 43.0％, 14.0％,35.5％ and 7.5％,respectively;the positive percentages of HBeAg in patients with the four serological patterns were 55.O％ in H/L,38.5％ in H/H,18.2％ in UL and 14.3％ in L/H group;there was a significant difference for the HBV DNA levels as compared between H/L and UL group (P=0.016),but not between H/L and H/H group(P=0.569)or H/H and L/L group (P=0.095). Concluson The lower serum HBsAg level combined with higher anti-HBs level were accompanied with lower rates of HBeAg positivity and lower HBV DNA level in patients with HBsAg and anti-HBs coexistence.%目的 探讨慢性HBV感染者HBsAg和抗-HBs共存的不同血清学模式及其意义.方法 在3042例慢性HBV感染者中筛选出HBsAg和抗-HBs共存患者93例,分析其临床特征、HBsAg和抗-HBs相对滴度模式、HBeAg状态和HBV DNA水平.结果 根据HBsAg和抗-HBs水平的高(H)或低(L),将HBsAg+/抗-HBs+血清学模式分为H/L、H/H、L/L和L/H四型,分别占43.0%、14.0%、35.5%和7.5%;其HBeAg+比例依次为H/L(55.0%)＞H/H(38.5%)＞L/L(18.2%)＞L/H(14.3%);H/L与L/L型患者HBV DNA水平之间差别显著(P＝0.016),而在H/L与H/H(P＝0.569)以及H/H与L/L之间(P＝0.095)均无显著性差别.结论 在HBsAg和抗-HBs共存患者,HBsAg水平越低和抗-HBs水平越高,则HBeAg阳性率和HBV DNA水平越低.