中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2013年
3期
189-191
,共3页
张仁芳%刘莉%郑毓芳%沈银忠%陈军%顾士民%王江蓉%卢洪洲
張仁芳%劉莉%鄭毓芳%瀋銀忠%陳軍%顧士民%王江蓉%盧洪洲
장인방%류리%정육방%침은충%진군%고사민%왕강용%로홍주
肝炎,乙型%获得性免疫缺陷综合征%隐匿性乙型肝炎
肝炎,乙型%穫得性免疫缺陷綜閤徵%隱匿性乙型肝炎
간염,을형%획득성면역결함종합정%은닉성을형간염
Hepatitis B%Acquired immunodeficiency syndrome%Occult hepatitis B
目的 观察未经抗病毒治疗(ART)的人类免疫缺陷病毒(HIV)感染者和普通人群隐匿性乙型肝炎流行状况,评估HIV感染者合并隐匿性乙型肝炎的临床特点.方法 通过酶联免疫分析法检测未经ART治疗的HIV感染者和普通人群血浆HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc水平,筛查出HBsAg阴性的HIV感染者(感染组)249例,健康体检者HBsAg阴性者121例(健康组),再采用罗氏COBASAmpliPrep/COBAS TaqManHBVTest,version2.0试剂盒检测外周血HBV DNA水平.统计分析用STATA 10软件处理本实验各组数据.用Fisher's精确概率检验、秩和检验.结果 感染组HBV DNA阳性者24例,隐匿性乙型肝炎占9.7％;健康组HBV DNA阳性者4例,隐匿性乙型肝炎占3.3％,两组比较,P=0.035,差异有统计学意义.感染组24例HBVDNA阳性者,HBV DNA载量最低者血中能测到,但在检测值水平以下,(即＜20 IU/ml),最高者3.22×105 IU/ml.大于100 IU/ml占37.5％(9/24),20 ～ 99 IU/ml占16.7％ (4/24),＜20IU/ml,但可测出HBV DNA占45.8％ (11/24).HIV感染者抗-HBc(+)/抗-HBs(+)组、抗-HBc(+)/抗-HBs(-)组、抗-HBc(-)/抗-HBs(+)组、抗-HBc(-)/抗-HBs(-)组DNA阳性率分别为7.3％ (8/110),20.8％ (11/53),14.3％ (3/21),3.1％(2/64),抗-HBc(+)/抗-HBs(-)组分别与抗-HBc(+)/抗-HBs(+)组、抗-HBc(-)/抗-HBs(-)组两组比较,P值分别为0.018和0.003,差异有统计学意义.四组间HBV DNA病毒载量比较,P=0.805,差异无统计学意义.感染组HBV DNA(+)组与HBV DNA(-)组比较,CD4计数(Z=1.902,P=0.0586)和ALT水平(Z=1.401,P=0.1611)差异无统计学意义.结论 在未经ART治疗HIV感染者中,隐匿性乙型肝炎高于普通人群,HIV感染者抗-HBc(+)/抗-HBs(-)组隐匿性乙型肝炎最高.
目的 觀察未經抗病毒治療(ART)的人類免疫缺陷病毒(HIV)感染者和普通人群隱匿性乙型肝炎流行狀況,評估HIV感染者閤併隱匿性乙型肝炎的臨床特點.方法 通過酶聯免疫分析法檢測未經ART治療的HIV感染者和普通人群血漿HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc水平,篩查齣HBsAg陰性的HIV感染者(感染組)249例,健康體檢者HBsAg陰性者121例(健康組),再採用囉氏COBASAmpliPrep/COBAS TaqManHBVTest,version2.0試劑盒檢測外週血HBV DNA水平.統計分析用STATA 10軟件處理本實驗各組數據.用Fisher's精確概率檢驗、秩和檢驗.結果 感染組HBV DNA暘性者24例,隱匿性乙型肝炎佔9.7％;健康組HBV DNA暘性者4例,隱匿性乙型肝炎佔3.3％,兩組比較,P=0.035,差異有統計學意義.感染組24例HBVDNA暘性者,HBV DNA載量最低者血中能測到,但在檢測值水平以下,(即＜20 IU/ml),最高者3.22×105 IU/ml.大于100 IU/ml佔37.5％(9/24),20 ～ 99 IU/ml佔16.7％ (4/24),＜20IU/ml,但可測齣HBV DNA佔45.8％ (11/24).HIV感染者抗-HBc(+)/抗-HBs(+)組、抗-HBc(+)/抗-HBs(-)組、抗-HBc(-)/抗-HBs(+)組、抗-HBc(-)/抗-HBs(-)組DNA暘性率分彆為7.3％ (8/110),20.8％ (11/53),14.3％ (3/21),3.1％(2/64),抗-HBc(+)/抗-HBs(-)組分彆與抗-HBc(+)/抗-HBs(+)組、抗-HBc(-)/抗-HBs(-)組兩組比較,P值分彆為0.018和0.003,差異有統計學意義.四組間HBV DNA病毒載量比較,P=0.805,差異無統計學意義.感染組HBV DNA(+)組與HBV DNA(-)組比較,CD4計數(Z=1.902,P=0.0586)和ALT水平(Z=1.401,P=0.1611)差異無統計學意義.結論 在未經ART治療HIV感染者中,隱匿性乙型肝炎高于普通人群,HIV感染者抗-HBc(+)/抗-HBs(-)組隱匿性乙型肝炎最高.
목적 관찰미경항병독치료(ART)적인류면역결함병독(HIV)감염자화보통인군은닉성을형간염류행상황,평고HIV감염자합병은닉성을형간염적림상특점.방법 통과매련면역분석법검측미경ART치료적HIV감염자화보통인군혈장HBsAg、항-HBs、HBeAg、항-HBe화항-HBc수평,사사출HBsAg음성적HIV감염자(감염조)249례,건강체검자HBsAg음성자121례(건강조),재채용라씨COBASAmpliPrep/COBAS TaqManHBVTest,version2.0시제합검측외주혈HBV DNA수평.통계분석용STATA 10연건처리본실험각조수거.용Fisher's정학개솔검험、질화검험.결과 감염조HBV DNA양성자24례,은닉성을형간염점9.7％;건강조HBV DNA양성자4례,은닉성을형간염점3.3％,량조비교,P=0.035,차이유통계학의의.감염조24례HBVDNA양성자,HBV DNA재량최저자혈중능측도,단재검측치수평이하,(즉＜20 IU/ml),최고자3.22×105 IU/ml.대우100 IU/ml점37.5％(9/24),20 ～ 99 IU/ml점16.7％ (4/24),＜20IU/ml,단가측출HBV DNA점45.8％ (11/24).HIV감염자항-HBc(+)/항-HBs(+)조、항-HBc(+)/항-HBs(-)조、항-HBc(-)/항-HBs(+)조、항-HBc(-)/항-HBs(-)조DNA양성솔분별위7.3％ (8/110),20.8％ (11/53),14.3％ (3/21),3.1％(2/64),항-HBc(+)/항-HBs(-)조분별여항-HBc(+)/항-HBs(+)조、항-HBc(-)/항-HBs(-)조량조비교,P치분별위0.018화0.003,차이유통계학의의.사조간HBV DNA병독재량비교,P=0.805,차이무통계학의의.감염조HBV DNA(+)조여HBV DNA(-)조비교,CD4계수(Z=1.902,P=0.0586)화ALT수평(Z=1.401,P=0.1611)차이무통계학의의.결론 재미경ART치료HIV감염자중,은닉성을형간염고우보통인군,HIV감염자항-HBc(+)/항-HBs(-)조은닉성을형간염최고.
Objective To investigate and analyze the differential prevalence,as well as the risk factors and clinical features,of occult hepatitis B virus (HBV) infection in the human immunodeficiency virus (HIV)-infeeted population without antiretroviral therapy (ART) as compared to the general (non-HIV-infected) population.Methods Two-hundred-and-forty-eight individuals with confirmed HIV infection but ART naive (males:220,females:28；15-82 years old) were enrolled in the study,along with 121 healthy individuals (confirmed HIV antibody-negative；males:53,females:68；20-88 years old).HBV markers (hepafits B surface antigen (HBsAg)；hepatitis B e antigen (HBeAg)；anti-HBs,anti-HBe and anti-hepatitis B core (HBc) antibodies) were detected by microparticle enzyme-linked immunosorbent assay (AxSYM immunology analyzer manufactured by Abbott Laboratories)；all cases and controls were confirmed negative for hepatitis B surface antigen (HBsAg).Then,the HBV DNA level in serum was detected using nucleic acid amplification assay (COBAS AmpliPrep/COBAS TaqMan HBV test,version 2.0 manufactured by Roche).CD4+ T lymphocytes were measured by flow cytometry,and alanine aminotransferase (ALT,marker of liver function) was measured by enzymatic assay.Results Twenty-four of the HIV cases (9.7％) and four of the healthy controls (3.3％) tested positive for HBV DNA；the amount of individuals with HBV DNA-positivity was significantly higher in the HIV-infected group (P =0.035).Among the 24 cases of HBV DNA(+) HIV-infected individuals,the lowest HBV DNA load was ＜ 20 IU/ml and the highest was 3.22 x 105 IU/ml；nine of the individuals (37.5％) had HBV DNA load ＞ 100 IU/ml,four (16.7％) had 20-99 IU/ ml,and 11 (45.8％) had ＜ 20 IU/ml.Among the total HIV-infected cases with HBV DNA-positivity,7.3％(8/110) were anti-HBe(+)/anti-HBs(+),20.8％ (11/53) were anti-HBc(+)/anti-HBs(-),14.3％ (3/21) were anti-HBc(-)/anti-HBs(+),and 3.1％ (2/64) were anti-HBc(-)/anti-HBs(-).The amount of individuals with HBV DNA-positivity in the anti-HBc(+)/anti-HBs(-) group was significantly different from those in the anti-HBc(+)/anti-HBs(+) group (P =0.018) and the anti-HBc(-)/anti-HBs(-) group (P =0.003).However,multiple comparison of HBV DNA loads detected between the four groups of HBV marker status revealed no significant difference (P =0.805).Furthermore,statistical analysis provided no evidence to support that occult hepatitis B infection in HIV-infected individuals had any impact on CD4+ T lymphocytes count (Z =1.902,P =0.059) or ALT levels (Z =1.401,P =0.161).Conclusion HIV-infected individuals who are ART naive and HBsAg(-) have a higher incidence of HBV DNA-positivity than individuals in the general (non-HIV-infected) population.In addition,the highest rate of occult hepatitis B among the HIV-infected cases occurred among individuals who were anti-HBc(+)/anti-HBs(-).
