慢性肝病患者HCV与HBV重叠感染与预后

目的探讨ＨＣＶ与ＨＢＶ重叠感染对慢性肝病过程、预后及对乙型肝炎病毒复制的影响。方法应用第二代抗＿ＨＣＶＥＬＩＳＡ及ＲＴ＿ＰＣＲ法测定１８７例ＨＢｓＡｇ阳性慢性肝病患者抗＿ＨＣＶ及ＨＣＶ＿ＲＮＡ，并对ＨＣＶ与ＨＢＶ重叠感染者的肝损害，ＨＣＶ，ＨＢＶ间的相互作用及预后进行分析。结果抗＿ＨＣＶ，ＨＣＶ＿ＲＮＡ的阳性率在慢性肝炎（轻度）１３．３％，慢性肝炎（中～重度）１６．１％，肝硬变２２．７％，慢性重型肝炎６３．６％，肝细胞癌１３．３％。平均阳性率１８．２％，慢性重型肝炎抗＿ＨＣＶ，ＨＣＶ＿ＲＮＡ的检出率最高，明显高于肝脏损害的其他肝病（Ｐ＜０．０５），近半数以上ＨＣＶ慢性感染已与ＨＢＶ重叠感染。结论ＨＣＶ与ＨＢＶ重叠感染的慢性肝病患者预后较差。但并未发现ＨＣＶ对ＨＢＶ复制具有阻遏作用。

Role of hepatitis C virus and hepatitis B virus coinfection in patients with chronic liver diseases

AIMS To explore the role of hepatitis C virus(HCV) and hepatitis B virus(HBV) coinfection in patients with chronic liver diseases, including the course and prognosis of diseases and HBV reproduction. METHODS Antibodies to HCV and HCV_RNA were measured by second generation ELISA and RT_PCR methods in 178 HBsAg positive chronic liver diseases. The liver lesion, prognosis and interaction of HBV and HCV were also analysed in patients with double infection. RESULTS The incidence of anti_HCV and HCV_RNA was 13.3% in chronic persistent hepatitis, 16.1% in chronic active hepatitis, 22.7% in liver cihrrosis, 63.3% in chronic fulminate hepatitis and 13.3% in primary liver cancer, respectively. The average positive rate was 18.2% in all patients. The incidence of HCV infection in patients with fulminate hepatitis was significantly higher(P<0.05) than that in other groups. The coinfection rate of HBV and HCV was over 50% in HCV_positive patients with chronic liver diseases. CONCLUSIONS The prognosis in patients with double infection is poorer than that in other groups, but no inhabition in HBV reproduction is found in patients with hepatitis C.