乙型肝炎病毒 C 基因启动子基因变异与免疫学标志及DNA含量的临床研究

目的 研究乙型肝炎病毒（HBV）C基因启动子（Basic core promoter,BCP）基因变异与HBV感染者免疫学标志及HBV DNA含量的临床关系。方法 采用聚合酶链（PCR）微板核酸分子杂交及荧光定量PCR检测技术，对246例HBV感染者进行HBV BCP基因变异及HBV DNA含量测定。结果 在HBsAg/HBeAg/HBcAB,HBsAg/HBeAg/HBcAb及HBsAg/HBcAb阳性的HBV感染者中，HBV DNA的阳性率分别为97.5%(48/49),22.9%(25/109),31.1%(14/45);HBV BCP基因变异率分别为59.1%(29/49),11%(12/109)，13.3%(6/45)；HBV BCP基因变异组DNA含量均≥10^6cps/ml，明显高于非BCP基因变异组。肝硬化病人BCP基因变异明显高于其他组。结论 e抗原免疫学标志的转换仅对部分感染者预示着病毒的免疫清除和静息，单独依靠乙型肝炎免疫学标志并不能确切提示HBV的复制状态、病变程度及愈后。

Clinical study on the relationships between HBV C gene promotor gene mutation and immunological marker, HBV DNA concentration

Objective To investigate the relationships between HBV infected patients immunological marker, HBV DNA concentration, and clinical symptoms. Methods PCR microplate nucleotide acid hybridization\|ELISA and FQ PCR methods were applied in the analysis of HBV BCP gene matation and HBV DNA concentrtion in 246 HBV infected patients. Results In patients with HBsAg /HBeAg /anti HBc , HBsAg /anti HBeAb /anti HBcAb , and HBsAg /anti HBc , the HBV DNA positive rate were 97 9% (48/49), 22 9%(25/109), 31 1%(14/45) respectively, with the overall positive rate 42 85%(98/203) And the HBV BCP gene mutation rate were 59 1%(29/49), 11%(12/109), 13 3%(6/45) respectively, with the overall mutation rate 23 15%(47/203). In HBV BCP gene mutation group HBV DNA concentration of each specimen was more than 10 6cps/ml, which are significently higher than other groups( P <0 001). Conclusion Re evaluation of HBV infected patients with HBsAg /anti HBe /anti HBc and HBV BCP gene mutation is necessary. The immunological turnover of HBeAg indicates the immune clearance and rest of HBV only in part of HBV infected patients. The immunological marker should not be the sole factor upon which the HBV replication status, the dignosis and prognosis of patients are determinded.