Objective Study of the rare hepatitis B virus patients model cases which both the hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (HBsAb) were positive, and discussion of its cause and the clinical value. Methods serum markers of hepatitis B virus (HBV-M) was detected by microparticle enzyme immunoassay chemiluminescence (MEIA); HBV-DNA was detected by fluores--cence quantitative PCR method, alanine aminotransferase and aspartate aminotransferase were detected by colorimetric, and all the data were combined with the clinical features of patients for comprehensive analysis. Results 1) HBsAg and HBsAb double positive detection rate was 2.3％ in 15600 cases of hepatitis B patients, there was no significant difference in the positive rate of different sex groups and different age groups (P> 0.05); 2) HBsAg, HBsAb, HBeAb, HBcAb positive mode accounted for the highest proportion in all HBsAg and HBsAb double positive cases, the percentage was 57.9％; 3) the positive rate of HBV DNA in hepatitis B patients with HBeAg positive rate were higher than HBeAg negative group in all HBsAg and HBsAb double positive cases; and the incident rate of double variation nt 1762 A-T/nt 1764 G-A in HBeAg negative group was higher than that in HBeAg positive group. There were significant differences between two groups (P 0.05);在所有HBsAg与HBsAb双阳模式中, HBsAg、HBsAb、HBeAb、HB-cAb阳性模式比例最高, 占57.9％;HBsAg与HBsAb双阳模式中HBeAg阳性组乙肝患者的HBV DNA阳性率高于HBeAg阴性组;而HBeAg阴性组BCP双变异nt1762A-T/nt1764G-A发生率较HBeAg阳性组高;两组差异具有统计学意义 (P <0.05);慢性乙肝患者HBsAg与HBsAb双阳检出率均高于无症状携带者、乙肝后肝硬化、重型乙肝及乙肝肝癌 (P <0.05) .结论 HBsAg与HBsAb双阳性出现, 并不预示乙肝病毒传染性减弱, 而提示病毒基因有可能出现变异, 临床有必要通过检测血清HBV DNA来确定患者体内病毒是否处于复制状态, 为此部分HBsAg与HBsAb双阳性患者的个性化治疗提供一定临床帮助.
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