中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2015年
2期
132-136
,共5页
何水珍%苏成豪%沈理通%牛建军
何水珍%囌成豪%瀋理通%牛建軍
하수진%소성호%침리통%우건군
肝炎病毒,乙型%肝炎表面抗原,乙型%横断面研究
肝炎病毒,乙型%肝炎錶麵抗原,乙型%橫斷麵研究
간염병독,을형%간염표면항원,을형%횡단면연구
Hepatitis B virus%Hepatitis B surface antigens%Cross-sectional studies
目的 了解厦门市自然人群中乙型肝炎病毒(HBV)隐匿性感染的情况及特点.方法 于2006年9-10月采用分层随机抽样方法,选取厦门市1～59岁4 437名户籍人口作为研究对象;采集研究对象血清标本,问卷收集其基本信息、乙型肝炎疫苗接种史和肝病史等信息.采集的血清标本用于检测乙型肝炎血清标志物,采用多区段巢式PCR对乙型肝炎病毒表面抗原(HBsAg)阴性的标本进行HBV-DNA检测,扩增产物测序后进行基因型分析和HBsAg“a”表位关键性氨基酸突变分析.血清HBV-DNA检测阳性但HBsAg阴性定义为HBV隐匿性感染.结果 4 437名研究对象中,482例HBsAg阳性,3 955例HBsAg阴性.HBsAg阴性者中27例HBV-DNA检测阳性,隐匿性感染率为0.68％ (27/3 955).27例隐匿性感染者中有16例为基因B型,11例为基因C型;其中,有9例感染者中发现了3种能影响HBsAg“a”表位构象的氨基酸变异(M133T、T140I、G145R).在482例HBsAg阳性者中,312例S区成功测序.隐匿性感染者中基因C型感染率(40.74％,11/27)、疫苗接种比例(62.96％,17/27)、HBsAb阳性率(51.85％,14/27)、“a”表位关键性氨基酸突变的比例(33.33％,9/27)均高于HBsAg阳性感染者[22.76％ (71/312)、13.78％ (43/312)、0.32％ (1/312)、0.99％ (31/312);x2值分别为4.29、41.26、156.00、13.07,P值分别为0.038、＜0.001、＜0.001、＜0.001].而隐匿性感染者的年龄[(18.3±16.2)岁]低于显性感染者[(34.4±11.6)岁],差异有统计学意义(t =6.67,P＜0.001);HBeAb阳性率(11.11％,3/27)、HBcAb阳性率(62.96％,17/27)均低于HBsAg阳性感染者[74.36％ (232/312)、98.40％ (307/312);x2值分别为46.74、73.78,P值分别为＜0.001、＜0.001].结论 厦门市自然人群中隐匿性感染者C基因型感染率、疫苗接种比例、HBsAb阳性率及“a”表位关键氨基酸突变比例高于HBsAg阳性感染者;年龄、HBeAb阳性率及HBcAb阳性率低于HBsAg阳性感染者.
目的 瞭解廈門市自然人群中乙型肝炎病毒(HBV)隱匿性感染的情況及特點.方法 于2006年9-10月採用分層隨機抽樣方法,選取廈門市1～59歲4 437名戶籍人口作為研究對象;採集研究對象血清標本,問捲收集其基本信息、乙型肝炎疫苗接種史和肝病史等信息.採集的血清標本用于檢測乙型肝炎血清標誌物,採用多區段巢式PCR對乙型肝炎病毒錶麵抗原(HBsAg)陰性的標本進行HBV-DNA檢測,擴增產物測序後進行基因型分析和HBsAg“a”錶位關鍵性氨基痠突變分析.血清HBV-DNA檢測暘性但HBsAg陰性定義為HBV隱匿性感染.結果 4 437名研究對象中,482例HBsAg暘性,3 955例HBsAg陰性.HBsAg陰性者中27例HBV-DNA檢測暘性,隱匿性感染率為0.68％ (27/3 955).27例隱匿性感染者中有16例為基因B型,11例為基因C型;其中,有9例感染者中髮現瞭3種能影響HBsAg“a”錶位構象的氨基痠變異(M133T、T140I、G145R).在482例HBsAg暘性者中,312例S區成功測序.隱匿性感染者中基因C型感染率(40.74％,11/27)、疫苗接種比例(62.96％,17/27)、HBsAb暘性率(51.85％,14/27)、“a”錶位關鍵性氨基痠突變的比例(33.33％,9/27)均高于HBsAg暘性感染者[22.76％ (71/312)、13.78％ (43/312)、0.32％ (1/312)、0.99％ (31/312);x2值分彆為4.29、41.26、156.00、13.07,P值分彆為0.038、＜0.001、＜0.001、＜0.001].而隱匿性感染者的年齡[(18.3±16.2)歲]低于顯性感染者[(34.4±11.6)歲],差異有統計學意義(t =6.67,P＜0.001);HBeAb暘性率(11.11％,3/27)、HBcAb暘性率(62.96％,17/27)均低于HBsAg暘性感染者[74.36％ (232/312)、98.40％ (307/312);x2值分彆為46.74、73.78,P值分彆為＜0.001、＜0.001].結論 廈門市自然人群中隱匿性感染者C基因型感染率、疫苗接種比例、HBsAb暘性率及“a”錶位關鍵氨基痠突變比例高于HBsAg暘性感染者;年齡、HBeAb暘性率及HBcAb暘性率低于HBsAg暘性感染者.
목적 료해하문시자연인군중을형간염병독(HBV)은닉성감염적정황급특점.방법 우2006년9-10월채용분층수궤추양방법,선취하문시1～59세4 437명호적인구작위연구대상;채집연구대상혈청표본,문권수집기기본신식、을형간염역묘접충사화간병사등신식.채집적혈청표본용우검측을형간염혈청표지물,채용다구단소식PCR대을형간염병독표면항원(HBsAg)음성적표본진행HBV-DNA검측,확증산물측서후진행기인형분석화HBsAg“a”표위관건성안기산돌변분석.혈청HBV-DNA검측양성단HBsAg음성정의위HBV은닉성감염.결과 4 437명연구대상중,482례HBsAg양성,3 955례HBsAg음성.HBsAg음성자중27례HBV-DNA검측양성,은닉성감염솔위0.68％ (27/3 955).27례은닉성감염자중유16례위기인B형,11례위기인C형;기중,유9례감염자중발현료3충능영향HBsAg“a”표위구상적안기산변이(M133T、T140I、G145R).재482례HBsAg양성자중,312례S구성공측서.은닉성감염자중기인C형감염솔(40.74％,11/27)、역묘접충비례(62.96％,17/27)、HBsAb양성솔(51.85％,14/27)、“a”표위관건성안기산돌변적비례(33.33％,9/27)균고우HBsAg양성감염자[22.76％ (71/312)、13.78％ (43/312)、0.32％ (1/312)、0.99％ (31/312);x2치분별위4.29、41.26、156.00、13.07,P치분별위0.038、＜0.001、＜0.001、＜0.001].이은닉성감염자적년령[(18.3±16.2)세]저우현성감염자[(34.4±11.6)세],차이유통계학의의(t =6.67,P＜0.001);HBeAb양성솔(11.11％,3/27)、HBcAb양성솔(62.96％,17/27)균저우HBsAg양성감염자[74.36％ (232/312)、98.40％ (307/312);x2치분별위46.74、73.78,P치분별위＜0.001、＜0.001].결론 하문시자연인군중은닉성감염자C기인형감염솔、역묘접충비례、HBsAb양성솔급“a”표위관건안기산돌변비례고우HBsAg양성감염자;년령、HBeAb양성솔급HBcAb양성솔저우HBsAg양성감염자.
Objective To investigate the prevalence of occult HBV infection in the normal population in Xiamen.Methods 4 437 registered permanent residents,aged 1-59 years old,were selected in Xiamen using stratified random sampling method from September to October in 2006.Serum samples were obtained,the basic characteristics,inoculation of HBV vaccine,and liver disease were surveyed.The serum samples were tested five HBV seroimmunological markers.The HBsAg-negative specimens were subjected to HBV-DNA detection by nested PCR targeting for multiple gene segments.The amplified products were sequenced and the sequence was used for determination of HBV genotype and mutation analysis of amino acids located in HBsAg "a" epitope.Subjects with serum detectable HBV-DNA and negative result of HBsAg were considered as occult HBV infection.Results Among the 4 437 subjects,482 individuals were observed HBsAg positive and 3 944 were observed negative.Of the 3 955 HBsAg-negative specimens,27 occult HBV infections were determined with the positive rate of 0.68％ (27/3 955).There were 16 samples with genotype B and 11 with genotype C.3 types of amino acid (AA) mutation (M133T,T140I,GI45R) that influence "a" epitope conformation were observed in 9 subjects with occult HBV infection.S region was successfully sequenced in 312 of the 482 HBsAg positive samples.In subjects with occult HBV infection,the infection rate of genotype C HBV (40.74％,11/27),inoculation rate of HBV vaccine(62.96％,17/27),positive rate of HBsAb (51.85％,14/27),and mutation rate of critical amino acid of "a" epitope (33.33％,9/27) were higher than HBsAg positive individuals (22.76％ (71/312),13.78％ (43/312),0.32％ (1/312),0.99％ (31/312),respectively),and all the difference were significant(x2 =4.29,41.26,156.00,13.07,respectively,and P value =0.038,＜ 0.001,＜ 0.001,＜0.001,respectively).While the average age in subjects with occult HBV infection (18.3 ± 16.2) were lower than that in HBsAg positive infection (34.4 ± 11.6),and the difference was significant (t =6.67,P ＜ 0.001).The reactive rate of HBeAb (11.11％,3/27) and HBcAb (62.96％,17/27) in subjects with occult HBV infection were lower than that in HBsAg positive infection (74.36％ (232/312),98.40％ (307/312)),and the difference were significant (x2 =46.74,73.78,respectively,and P value ＜0.001,＜0.001,respectively).Conclusion In normal population in Xiamen,the infection rate of genotype C,the positive rate of HBsAb,the HBV vaccination rate,and the key AA mutation rate in "a" epitope are significantly higher in occult HBV infection than in HBsAg positive infection,and the age,the positive rate of HBeAb and HBcAb are significantly lower.
