用套式聚合酶链反应检测乙型肝炎疫苗免疫后无抗体反应者血清…

为了解乙型肝炎（乙肝）疫苗接种后不产生抗－ＨＢｓ的原因，作者用套式聚合酶链反应（ＰＣＲ）技术检测了正常人君中乙肝疫苗免疫后１５例不产生抗－ＨＢｓ和２０例产生抗－ＨＢｓ者血清的ＨＢＶ ＤＮＡ，同时用Ａｂｂｏｔｔ试剂检测血清的ＨＢｅＡｇ。结果发现，不产生抗－ＨＢｓ者的１５例中有６例（４０％）第２次ＰＣＲ扩增ＨＢＶ ＤＮＡ为阳性，其中３例（５０％）为ＨＢｅＡｇ阳性，产生抗－ＨＢｓ者的２０例其血清ＨＢＶ     

HBV感染者血清HBeAg/IC和HBV DNA间的关系

资料与方法：ＨＢＶ感染者１１７例,正常对照２０例,研究对象排除其它肝炎病毒感染,半年内未经抗病毒及免疫治疗。采用ＥＬＩＳＡ及Ｎａｓｔｅｄ－ＰＣＲ方法分别检测ＨＢＶ感染者血清中ＨＢｅＡｇ／免疫复合物（ＩＣ）和ＨＢＶ ＤＮＡ。 结果：１１７例ＨＢＶ感染者血清中共检出ＨＢｅＡｇ／ＩＣ阳性２３例,ＨＢＶＤＮＡ阳性 ５５例, ＨＢｅＡｇ／ＩＣ阳性者中 ＨＢＶＤＮＡ阳性率为９１．３％（２１／２３例）,而ＨＢｅＡｇ／ＩＣ阴性的９４例中ＨＢＶ ＤＮＡ阳性３４例,阳性率为３６．２％,两组差异有非常显著性,ｘ２＝８．１５…     

聚合酶链反应检测HBV－DNA的临床意义

本文采用聚合酶链反应（ＰＣＲ）和ＥＬＩＳＡ法对２７３７例乙肝患者血清中ＨＢＶ－ＤＮＡ和乙肝病毒标志物进行检测，结果发现各组ＨＢＶ－ＤＮＡ的检出率：①ＨＢｓＡｇ（＋）、ＨＢｅＡｇ（＋）和抗ＨＢｃ（＋）组为９９．２７％；②ＨＢｓＡｇ（＋）、抗ＨＢｅ（＋）和抗ＨＢｃ（＋）组为４４．７７％；③ＨＢｓＡｇ（＋）和抗ＨＢｃ（＋）组为４２．８６％；④ＨＢＶ标志物均阴性为１５．９２％。结果表明ＨＢＶ－ＤＮＡＰＣＲ检出先于其它乙肝病毒标志物，可早期发现乙肝。ＰＣＲ法直接检测ＨＢＶ－ＤＮＡ更有利于临床对乙肝的诊断和治疗。     

以聚合酶链反应法研究乙型肝炎HBV－DNA与e系统的关系

本文采用聚合酶链反应（ＰＣＲ）法检测了１２２例乙型肝炎患者血清ＨＢＶＤＮＡ。对照患者ｅ系统的模式，发现ＨＢｅＡｇ（＋），抗－ＨＢｅ（－）者ＨＢＶＤＮＡ阳性率为９０．９％，抗－ＨＢｅ（＋）、ＨＢｅＡｇ（－）者ＨＢＶＤＮＡ阳性率为５０．１％，ＨＢｅＡ（－）、抗－ＨＢｅ（－）者ＨＢＶＤＮＡ阳性率为３５．７％。结果表明，ＰＣＲ法较ｅ系统更能准确反映ＨＢＶ的复制情况。     

以聚合酶链反应法研究乙型肝炎HBV—DNA与e系统的关系

本文采用聚合酶链反应（ＰＣＲ）法检测了１２２例乙型肝炎患者血清ＨＢＶＤＮＡ。对照患者ｅ系统的模式，发现ＨＢｅＡｇ（＋），抗－ＨＢｅ（－）者ＨＢＶＤＮＡ阳性率为９０．９％，抗－ＨＢｅ（＋），ＨＢｅＡｇ（－）者ＨＢＶＤＮＡ阳性率为５０．１％，ＨＢｅＡｇ（－），抗－ＨＢｅ（－）者的ＨＢＶＤＮＡ阳性率为３５．７％。结果表明，ＰＣＲ法较ｅ系统更能准确反映了ＨＢＶ的复制情况。     

CPH肝组织,血清HBV与血清HBV标志物不同状态的相关性探讨

目的和方法：经肝活检诊断为慢性迁延性肝炎（ＣＰＨ）５１例，均做ＰＣＲ、斑点杂交进行肝组织、血清ＨＢＶＤＮＡ检测，同时用ＥＬＩＳＡ方法检测了ＨＢＶ血清标志物。结果，ＨＢＶＤＮＡ检出率依次为肝组织ＰＣＲ９４１％（４８／５１）、血清ＰＣＲ９２２％（４７／５１）和肝组织斑点杂交９０２％（４６／５１）。三者之间无显著差异（χ２＝０４９５，Ｐ＞００５）。各项血清标志物总检出率ＨＢｓＡｇ３７２％（１９／５１），ＨＢｅＡｇ３３３％（１７／５１）和抗－ＨＢｅ２１５％（１１／１５），显著低于ＰＣＲ和斑点杂交ＨＢＶＤＮＡ的检出率（χ２＝３０．９，Ｐ＜０００５）。在抗－ＨＢｅ（＋）的１１例患者中１０例检出肝组织和血清ＨＢＶＤＮＡ，８例抗－ＨＢｓ（＋）患者，６例肝组织及血清ＰＣＲＨＢＶＤＮＡ阳性，结论：表明抗－ＨＢｅ（＋）及／或抗－ＨＢｓ（＋）不能代表ＨＢＶ复制停止或被清除，并且肝脏病变可仍然存在     

套式及免疫套式聚合酶链反应检测乙型肝炎表面抗原阴性肝病患者血清中乙型肝炎病毒DNA

为了更准确、简便而又快速地了解乙型肝炎表面抗原（ＨＢｓＡｇ）阴性肝病患者的病因，建立了套式和免疫套式聚合酶链反应（ＰＣＲ）检测血清中乙型肝炎病毒（ＨＢＶ）ＤＮＡ的技术，结合丙型肝炎病毒（ＨＣＶ）感染指标的检测，对ＨＢｓＡｇ阴性肝病患者的病因进行了研究。发现套式ＰＣＲ能将单次ＰＣＲ的敏感性稳定地提高１０００倍；免疫套式ＰＣＲ可检测到０．１～０．０１ｐｇ／Ｌ水平。检测ＨＢｓＡｇ阴性肝硬化２２例（Ａ组）、ＨＢｓＡｇ阴性慢性肝炎１３例（Ｂ组）、ＨＢｓＡｇ阴性和乙型肝炎病毒核心抗体（抗－ＨＢｃ）阳性正常对照组３０例（Ｃ组）及ＨＢｓＡｇ（＋）／ＨＢｅＡｇ（－）肝硬化患者１２例（Ｄ组），分别有４５．５％、３０．８％、１３．３％和１００％患者血清中ＨＢＶＤＮＡ阳性。ＨＢＶＤＮＡ在一些抗－ＨＢｓ（＋）肝病患者和所谓健康人的血清中也存在。Ａ、Ｂ两组检出有ＨＢＶ和（或）ＨＣＶ感染患者分别占８１．８％和５３．８％。提示套式和免疫套式ＰＣＲ是简便、快速而又高度敏感的检测方法；ＨＢＶ感染可能是引起ＨＢｓＡｇ阴性慢性肝病的重要原因，且ＨＢｓＡｇ阴性肝病病因大多与病毒感染有关；应该重新认识自然感染者血清中抗－ＨＢｓ的临床意义。     

多聚酶链式反应在慢性乙型肝炎血清学标志物检测中的应用

作者应用多聚酶链式反应检测９５例慢性乙型肝炎患者的血清标本，ＨＢｓＡｇ、ＨＢｅＡｇ、抗－ＨＢｃ阳性组，ＨＢｓＡｇ、抗－ＨＢｅ、抗－ＨＢｃ阳性组，ＨＢｓＡｇ、抗－ＨＢｃ阳性组，抗－ＨＢｓ阳性组，抗－ＨＢｅ，抗－ＨＢｃ阳性组其ＨＢＶＤＮＡ阳性率分别为９６．５５％（２８／２９例），７８．９５％（１５／１９例），４０％（８／２０），２０％（２／１０例），１０％（１／１０例），并提出乙型肝炎病毒复制和传染性     

聚合酶链反应评价原位杂交检测慢性HBV感染者肝内HBVDNA的结果

用地高辛素探针原位杂交检测慢性ＨＢＶ感染者肝内ＨＢＶＤＮＡ，聚合酶链反应（ＰＣＲ）检测血清ＨＢＶＤＮＡ评价病毒复制状态。发现肝内ＨＢＶＤＮＡ阳性肝细胞，在１４例肝组织病变不活动的ＨＢｅＡｇ阳性慢性无症状ＨＢＶ携带者（ＡｓＣ）呈弥漫性分布；而在ＨＢｅＡｇ阳性或阴性活动性肝病病人均聚合分布于肝细胞坏死区。上述慢性感染者９８％血清ＨＢＶＤＮＡ阳性。说明ＨＢＶ复制与肝组织病变有关但非肝损伤直接原因。１６例ＨＢｅＡｇ阴性ＡｓＣ中，９例肝内仅见局灶性ＨＢＶＤＮＡ阳性肝细胞，其中４例血清ＨＢＶＤＮＡ阳性，说明部分ＨＢｅＡｇ阴性ＡｓＣ也存在极低水平病毒复制。     

聚合酶链反应检测HBV DNA的临床意义

应用ＰＣＲ对１７１例肝病血清检测结果，ＨＢＶＤＮＡ阳性率５９．１％，ＥｌｉＳＡ检测ＨＢｓＡｇ阳性率４３．２７％，二者比较有显著性差异（Ｐ〈０．０１），ＨＢｓＡｇ（＋）／ＨＢｅＡｇ（＋）组ＨＢＶＤＮＡ阳性率７９．５％，而ＨＢｓＡｇ（＋）抗－ＨＢｅ（＋）组主５７．９％，ＨＢｓＡｇ（－）／抗－ＨＢｓ（＋）组，ＨＢＶＤＮＡ阳性率３６．８％。     

Clinical, biochemical, immunological and virological profiles of, and differential diagnosis between, patients with acute hepatitis B and chronic hepatitis B with acute flare

Background and Aim: In areas with high or intermediate endemicity for chronic hepatitis B virus (HBV) infection, it is difficult to distinguish acute hepatitis B (AHB) from chronic hepatitis B with an acute flare (CHB‐AF) in patients whose prior history of HBV infection has been unknown. The present study aimed to screen laboratory parameters other than immunoglobulin M antibody to hepatitis B core antigen (IgM anti‐HBc) to discriminate between the two conditions. Methods: A retrospective and prospective study was conducted in patients first presenting clinically as HBV‐related acute hepatitis to sort out acute self‐limited hepatitis B (ASL‐HB). Then, clinical and laboratory profiles were compared between patients with ASL‐HB and CHB‐AF. Parameters closely associated with ASL‐HB were chosen to evaluate sensitivity, specificity, accuracy, positive predictive values and negative predictive values for diagnosing AHB. Results: There were significant differences between patients with ASL‐HB and CHB‐AF in relation to clinical and laboratory aspects, with many outstanding differences in levels of serum HBV‐DNA, hepatitis B e antigen (HBeAg) and alpha‐fetoprotein (AFP) as well as IgM anti‐HBc. In particular, there was a greater difference between the two groups in low levels of HBeAg (ratio of the optical density of the sample to the cut‐off value [S/CO] <20) than in negativity for HBeAg (42.7% and 13.5% vs 49.3% and 45.9%). 1:10 000 IgM anti‐HBc had a sensitivity and specificity of 96.2% and 93.1%, respectively, for predicting ASL‐HB. Combining it with AFP, HBeAg or HBV‐DNA could improve diagnostic power. A combination of IgM anti‐HBc, HBV‐DNA and HBeAg had a predictive value of 98.9% and a negative predictive value of 100.0%, similar to that of a combination of IgM anti‐HBc and HBV‐DNA. Adding AFP to the combinations of IgM anti‐HBc and HBV‐DNA or HBeAg could further heighten the positive predictive value. The positive predictive value and negative predictive value of the combination of IgM anti‐HBc, HBV‐DNA and AFP were both 100.0%. Conclusions: (i) There are significant differences with respect to clinical, biochemical, immunological and virological aspects between ASL‐HB and CHB‐AF. (ii) Of several diagnostic combinations, IgM anti‐HBc jointing HBV‐DNA is most effective and most practicable in distinguishing ASL‐HB from CHB‐AF. (iii) A low HBeAg level is more useful than negative HBeAg in differential diagnosis between ASL‐HB and CHB‐AF. (iv) In those patients with a high level of IgM anti‐HBc, serum AFP level >10× upper reference limit could rule out a probability of ASL‐HB.     

Assessment of chronic hepatitis B: the importance of hepatitis B virus DNA testing

Background: Chronic hepatitis B (CHB) has an estimated prevalence of 90 000 to 160 000 in Australia. Cirrhosis and hepatocellular carcinoma are important complications of CHB and appropriate evaluation of hepatitis B surface antigen (HBsAg)‐positive individuals is vital to identify treatment candidates. Methods: A review of the database of a tertiary hospital was performed and 348 HBsAg‐positive individuals with baseline demographic, virological, serological and biochemical variables were identified and evaluated cross‐sectionally. A small subgroup of hepatitis B e antigen (HBeAg)‐negative patients with normal alanine aminotransferase (ALT) at baseline were identified and followed longitudinally. Results: 175/348 (50%) of patients were in the HBeAg‐negative, chronic hepatitis phase of disease, 22% in the HBeAg‐positive immune clearance and 6% in the immune tolerant phases. HBeAg‐negative patients were older and more likely to be male than HBeAg‐positive patients. The correlation between hepatitis B virus (HBV) DNA and ALT levels was examined. ALT and HBV DNA levels showed no correlation in HBeAg‐positive CHB and only a weak correlation in HBeAg‐negative patients. Furthermore, 35% of HBeAg‐negative patients with detectable HBV DNA had a normal ALT. Conversely 38% of HBeAg‐negative patients with no detectable HBV DNA had an elevated ALT. A persistently normal ALT over 24 months was seen in five of nine HBeAg‐negative patients with normal initial ALT and detectable HBV DNA. Conclusion: Appropriate evaluation of HBeAg‐negative CHB must include HBV DNA because the ALT is not a reliable guide to underlying viral replication.     

Clinical characteristics and distribution of hepatitis B virus genotypes in Guangxi Zhuang population

AIM: To investigate the distribution of HBV genotypes and their YMDD mutations in Guangxi Zhuang population, China, and to study the relationship between HBV genotypes and clinical types of HB, ALT, HBV DNA, HBe system as well as the curative effect of Lamivudine (LAM) on hepatitis B. METHODS: A total of 156 cases were randomly chosen as study subjects from 317 patients with chronic hepatitis B (CHB). HBV genotypes were determined by PCR-microcosmic nucleic acid cross-ELISA. YMDD mutations were detected by microcosmic nucleic acid cross-nucleic acid quantitative determination. HBV DNA was detected by fluorescence ratio PCR analysis. LAM was given to 81 cases and its curative effect was observed by measuring ALT, HBV DNA load, HBeAg, and HBeAg/HBeAb conversion rate. RESULTS: HBV genotypes B, C, D, and non-classified genotypes were found in Guangxi Zhuang population, accounting for 25.6%, 47.4%, 58.3%, and 16.0%, respectively. Seventy-four cases were CD-, CB-, BD-mixed genotypes (47.7%). Forty-six (29.5%) cases had YMDD mutations. Genotype B was mostly found in mild and moderate CHB patients. Genotypes C, D and mixed genotype mostly occurred in severe CHB cases. Genotypes D and CD HBV-infected patients had higher ALT and HBV DNA than patients with other types of HBV infection. There was no significant difference among the genotypes in YMDD mutations, clinical types, ALT and HBV DNA level. Non-classified types geno had a significantly lower positive rate of HBeAg than other genotypes (X2=12.841,P<0.05). There was no significant difference in ALT recovery rate, HBV DNA load, HBeAg, and HBeAg/HBeAb conversion rate, 48 wk after LAM treatment between groups of genotypes D, CD, and non-classified type. CONCLUSION: Genotypes B, C, and D, non-classified and mixed genotype of HBV are identified in the Guangxi Zhuang population. Variations in genotypes are associated with clinical severity and serum ALT levels, but not with YMDD mutation or HBV DNA load. Therapeutic effects of LAM on clinical parameters are not influenced by differences in genotypes. Further studies are needed to gain an in-depth understanding of the relationship between HBV genotypes and serum HBeAb and HBeAg.     

乙型肝炎病毒e抗原阳性孕妇所生婴儿联合免疫接种后乙型肝炎病毒血清学标志物的动态变化

目的 观察HBeAg阳性且HBV DNA高载量孕妇所生婴儿用乙型肝炎疫苗联合免疫接种后的母婴阻断效果及HBV血清学标志物的动态变化.方法 回顾性分析HBeAg阳性且HBVDNA≥106拷贝/ml孕妇127例,婴儿出生后即刻及第15天于臀大肌注射高效价乙型肝炎免疫球蛋白200 IU,出生时与第1、6个月于右上臂肌肉注射乙型肝炎疫苗20μg,随访其婴儿至12个月龄.用酶联免疫吸附法及荧光定量PcR检测婴儿出生时及第1、7、12个月时的HBV血清学标志物和HBV DNA载量,观察婴儿出生时HBV血清学标志物模式、母婴传播率、疫苗接种后的HBV宫内感染率、抗-HBs阳性保护率及HBV血清学标志物动态变化.结果 127例孕妇分娩婴儿均为单胎,出生时29例婴儿HBsAg为阳性,其中11例合并HBV DNA阳性,母婴垂直传播率为22.83％.随访至1个月,10例婴儿合并HBV DNA阳性从而发生HBV宫内感染,表现为HBsAg、HBeAg及抗-HBc均为阳性.2例婴儿HBsAg弱阳性,伴有抗-HBs滴度的产生,后续随访中均转阴,乙型肝炎宫内感染率为7.87％.非宫内感染婴儿出生时HBeAg及抗-HBc阳性率分别为96.58％和98.29％,免疫接种后婴儿HBeAg及抗-HBc逐步转阴,均未产生抗-Hbe.非宫内感染婴儿均产生有效乙型肝炎保护性抗体,乙型肝炎疫苗及高效价乙型肝炎免疫球蛋白联合免疫接种后,婴儿抗-HBs滴度从出生至12个月龄逐步上升,母源性HBeAg滴度逐步下降以至转阴.结论 乙型肝炎疫苗联合高效价乙型肝炎免疫球蛋白免疫接种能明显降低HBV母婴传播,增强婴儿乙型肝炎表面抗原保护性抗体,体内母源性HBeAg及抗-HBc亦随之降低甚至转阴.     

Mutations of pre-core and basal core promoter before and after hepatitis B e antigen seroconversion

AIM: To investigate the role of pre-core and basal core promoter(BCP) mutations before and after hepatitis Be antigen(HBe Ag) seroconversion.METHODS: The proportion of pre-core(G1896A) and basal core promoter(A1762T and G1764A) mutant viruses and serum levels of hepatitis B virus(HBV) DNA, hepatitis B surface antigen(HBs Ag), and HB core-related antigen were analyzed in chronic hepatitis B patients before and after HBe Ag seroconversion(n = 25), in those who were persistently HBe Ag positive(n = 18), and in those who were persistently anti-HBe positive(n = 43). All patients were infected with HBV genotype C and were followed for a median of 9 years.RESULTS: Although the pre-core mutant became predominant(24% to 65%, P = 0.022) in the HBe Ag seroconversion group during follow-up, the proportion of the basal core promoter mutation did not change. Median HBV viral markers were significantly higher in patients without the mutations in an HBe Ag positive status(HBV DNA: P = 0.003; HBs Ag: P < 0.001; HB core-related antigen: P = 0.001). In contrast, HBV DNA(P = 0.012) and HBs Ag(P = 0.041) levels were significantly higher in patients with the pre-core mutation in an anti-HBe positive status.CONCLUSION: There is an opposite association of the pre-core mutation with viral load before and after HBe Ag seroconversion in patients with HBV infection.     

Serum ALT levels as a surrogate marker for serum HBV DNA levels in HBeAg-negative pregnant women

In Stockholm, Sweden, the majority of pregnant women positive for hepatitis B surface antigen (HBsAg) are hepatitis Be antigen (HBeAg) negative. Newborns to HBeAg positive mothers receive vaccination and hepatitis B immunoglobulin (HBIg). Newborns to HBeAg negative mothers receive vaccine and HBIg only if the mothers have elevated ALT levels. The aim of this study was to retrospectively evaluate ALT levels as a surrogate marker for HBV DNA levels in HBeAg negative carrier mothers. Altogether 8947 pregnant women were screened for HBV markers from 1999 to 2001 at the Virology Department, Karolinska Hospital. Among mothers screened 192 tested positive for HBsAg (2.2%). 13 of these samples could not be retrieved. Of the remaining 179 sera, 8 (4%) tested positive for HBeAg and 171 (95.5%) were HBeAg negative. Among the HBeAg negative mothers, 9 had HBV DNA levels > 10(5) copies/ml, and of these 7 had normal ALT levels indicating low sensitivity of an elevated ALT level as a surrogate marker for high HBV DNA level. Furthermore, no correlation was found between ALT and HBV DNA levels. Hence, it is concluded that the use of ALT as a surrogate marker for high viral replication in HBeAg negative mothers could be questioned.     

乙型肝炎患者血清HBV标志物与HBV DNA相关性分析

目的探讨乙型肝炎患者血清学标志(HBVM)与HBV DNA的关系。方法对257例乙型肝炎患者同时检测HBVM与HBV DNA。HBVM检测用EHSA法，HBV DNA检测用PCR法。根据不同检测结果进行对比分析。结果在HBsAg HBeAg HBcAb阳性的血清中HBV DNA阳性率和含量最高，血清HBeAg与HBV DNA含量密切相关，但部分HBeAg阴性或抗-HBe阳性患者也有较高的HBV DNA阳性率及含量。结论PCR定量检测HBV DNA含量更有助于判断体内HBV复制的情况及传染性强弱，在临床上有重要意义。     

Serological assessment of HBcAg and HBV DNA: its prognostic relevance in acute hepatitis B

Treatment of serum precipitates with sodium thiocyanate in patients with hepatitis B virus (HBV) replication results in liberation of circulating hepatitis core antigen (HBcAg) which can be demonstrated radioimmunologically. Follow-up investigations were performed in 80 patients with acute hepatitis B. Sera were examined for HBcAg. HBV DNA and conventional HBV markers. At the time of admission to hospital 34 of 80 (42%) patients were HBeAg positive. Twenty-six (76%) of the 34 HBcAg positive patients were HBV DNA positive, and circulating HBcAg was detectable in 25 of 34 (73%) HBcAg positive cases. In patients with uncomplicated courses of acute hepatitis B the serological HBcAg assay and HBV DNA became negative 1 to 8 weeks before elimination of HBeAg and up to 12 weeks earlier than the sera became negative for HBsAg. Five patients (6%) showed transition to chronic hepatitis B with persistence of HBsAg, HBeAg, HBV DNA and HBcAg in serum. One patient with acute hepatitis B and development of chronic hepatitis suffered from acquired immunodeficiency syndrome and showed delayed formation of anti-HBc. In this case uncomplexed HBcAg was demonstrable during the acute phase of hepatitis B. With the appearance of anti-HBc HBcAg circulated in a complexed form. The data indicate that serological determinations of HBcAg and HBV DNA can serve as prognostic markers in the early phase of acute hepatitis B. The demonstration of uncomplexed HBcAg in serum of a patient with inadequate formation of anti-HBc supports the hypothesis that circulating HBcAg is usually complexed by specific antibodies.     

The Effect of the Hepatitis B Vaccine Derived from Genotype C on Infants Born to Mothers Infected with Genotype D

Objective There is a paucity of information on whether the hepatitis B virus (HBV) vaccine, derived from HBV genotype C, can prevent mother-to-child transmission of HBV genotype D. The aim of this study was to clarify this issue. Methods The subjects consisted of 25 children (8.5±4.1 years old, 7 males, 18 females), born to 17 mothers who were chronically infected with HBV genotype D. Of these, 20 children were inoculated with the genotype C-derived vaccine, one was inoculated with the genotype A-derived vaccine, and one was inoculated with both the A- and C-derived vaccines. Information on the type of vaccine given to the remaining three children was not available. The serum levels of HB surface antigen (HBsAg), antibody to HBsAg (anti-HBs), and antibody to HB core (anti-HBc) of the children, as well as HBV markers of the mothers, were examined. Results All mothers were positive for HBsAg (6,563±11,005 IU/mL), negative for HBeAg, and positive for anti-HBe. HBV-DNA levels (log IU/mL) were ＜3.3 in 7 mothers, 3.3-4.3 in 9 mothers, and ＞4.3 in one mother. HBsAg and anti-HBc were negative in all children, regardless of the type of vaccine used. Anti-HBs were positive in 13 children and negative in 12. Conclusion All children born to mothers infected with genotype D, including 20 who were inoculated with the genotype C-derived vaccine, were negative for both HBsAg and anti-HBc. These results suggest that the genotype C-derived HB vaccine is effective in preventing mother-to-child transmission from mothers infected with HBV genotype D.     

高复制型慢性乙型肝炎患者肝内HBV复制指标与肝脏病变的关系

33例均为HBsAg、HBeAg及抗HBc三项阳性(部分伴HBcAg、DNA P或HBV DNA阳性)。病理报告慢性小叶性肝炎6例,慢性持续性肝炎27例.应用Southern Blot法共查肝内HBV DNA25例,其中阳性13例(52％),包括游离型9例,游离十整合型2例,整合型2例,应用双桥PAP法共查HBsAg及HBcAg23例,其中HBsAg阳性15例(65.2％),HBcAg阳性11例(43.8％)。提示肝内HBV DNA及HBcAg阳性组各项旰脏病变检出率在50％以上,项目(7项)比阴性组(5项)为高,并与血中DNAP、HBV DNA复制指标及ALT异常率相一致,肝内HBV DNA游离型及游离十整合型各项肝脏病变检出率也比整合型为高。因而,慢乙肝肝脏病变持续存在,与乙肝病毒复制有关,抗病毒治疗应予重视。