慢性乙型肝炎急性发作与血清HBN DNA含量关系

目的 研究慢性乙型肝炎急性发作与血清ＨＢＶ ＤＮＡ含量的关系。方法 采用荧光ｍｐｌｉＳｅｎｓｏｒ）定量方法。测定一组自发性反复发作的慢性乙型肝炎患者发作前，中和后的血清ＨＢＶ ＤＮＡ含量的变化。结果 （１）１１例患者中有９例（８２％）血清ＨＢＶ ＤＮＡ含量的高峰值是在最大肝损害之前出现或与丙氨酸转氨酶（ＡＬＴ０同时达到高峰。

Relationship between HBV DNA serum level and acute exacerbation of the disease in chronic hepatitis B patients

OBJECTIVE: In this study, we evaluated the relationship between HBV DNA serum level and acute hepatic exacerbation of the disease in chronic hepatitis B patients. METHODS: A series of serum samples from 14 patients of acute exacerbation of chronic hepatitis B were analyzed for alteratieus in serum HBV DNA and alanine transaminase (ALT) level before, during, and after episode of an acute exacerbation. The serum HBV DNA concentrations were tested by the quantitative polymerase chain reaction (PCR) using the AmpliSensor assay. RESULTS: 1. Serum HBV DNA average level in 11 patients significantly increased from 7.148 +/- 2.008(logarithm) at 2-8 weeks before maximum injury of liver to 8.416 +/- 2.160 (logarithm), the time that ALT reached its peak, and then, following the declining of ALT level, decreased to 6.093 +/- 1.428 (logarithm). In 9 of 11 cases, the HBV DNA peak value occurred before the ALT peak level or at the same time; 2. Two patients who experienced several episodes of acute exacerbation showed that the appearance of acute hepatic injury and the relatively normal liver function occurred alternatively. Whereas, one patient with liver cirrhosis showed persistence of high level viremia in three episodes of acute exacerbation in one year. CONCLUSION: 1. This investigation revealed a clear correlation between increasing level of serum HBV DNA and acute exacerbation of patients with chronic hepatitis B. The findings suggest that host's immune response which causes acute exacerbation of liver injury in patients with chronic hepatitis B is triggered by the change of viremia and HBV replication; 2. Patients with severe chronic active hepatitis and persistent hepatitis B virus replication are at very high risk of rapid progression to cirrhosis.