HBV和HCV重叠感染患者生化免疫指标变化及临床意义

目的了解HBV和HCV重叠感染情况及其对肝功能及血清病毒载量的影响。方法常规检测3816例临床血清样本中的HBV及HcV血清标志物以及肝功能等指标，实时荧光定量PCR检测病毒载量。结果3816例送检样本中HBsAg阳性率8．9％（341／3816），抗HCV抗体阳性率1．2％（46／3816），其中HCVRNA检测阳性15例，现症感染率为0．39%。3816例样本中，HBV／HCV重叠感染15例，单纯HBV感染326例，单纯HCV感染31例。单纯HBV感染患者血清转氨酶（ALT和AST）及总胆红素（TBil）水平均明显高于重叠感染患者和单纯HCV感染患者。HBV／HCV重叠感染组患者HBVDNA栽量低于单纯HBV感染组，两组比较，差异有统计学意义（P〈0．05）；HBV／HCV重叠感染组患者HCVRNA载量也低于单纯HCV感染组，但两组比较，差异无统计学意义（P〉O．05）。结论重庆地区HBV／HCV感染情况与我国一般人群分布基本一致，重叠感染患者肝功能血清学指标改变低于单纯HBV感染患者。

Variation of Biological and Immune Indexes in Patients with HBV and HCV Verlapping Infection as Well as Its Clinical Significance

Objective To investigate the infection status of HBV and HCV overlapping and its effect on liver function and ser- um levels of viral load. Methods Liver function indicators and serum markers of HBV and HCV of 3 816 clinical serum samples were routinely detected. Serum viral load were determined by real-time fluorescent quantitative polymerase chain re： action. Results Among 3 816 samples,HBsAg positive rate was 8.9% （341/3 816）. Anti-HCV antibody positive rate was 1.2 % （46/3 816）, among them, 15 cases were positive for H CV RNA and current infection rate was 0. 39 %. 3 816 cases of samples, HBV/HCV overlapping infection in 15 cases,pure HBV infection in 326 cases, simple HCV infection in 31 cases. The serum （ALT and AST） and TBil levels in patients with pure HBV infection were significantly higher than those with o- verlapping infection or pure HCV infection. Serum viral loads of HBV DNA in patients with HBV/HCV overlapping infec- tion were lower than pure HBV infection, P valued 0.05, the difference was statistically significant. Serum viral loads of HCV RNA in patients with HBV/HCV overlapping infection were lower than pure HCV infection patients, but there was no statistically significant difference in the two groups （P〉0.05）. Conclusion Chongqing area of HBV/HCV infection sta- tus in Chongqing area were similar to the general population distribution in China. The change of liver function and serological indexes in patients with HBV/HCV overlapping infection were less distinct than pure HBV infection patients.