乙型肝炎患者血清中乙型肝炎病毒共价闭合环状DNA的检测

目的 检测不同肝脏病变程度的乙型肝炎患者外周血中的HBV共价闭合环状DNA(HBV cccDNA),评价其相关的影响因素和临床意义.方法 共观察57例乙型肝炎患者,其中轻度慢性乙型肝炎患者26例,重型乙型肝炎患者31例.患者入院后行PT、肝功能、肝炎病毒血清标志物等常规检测,并进行总HBV DNA和HBV cccDNA检测.Logistic逐步回归分析影响血清HBVcecDNA检出率的相关因素.结果重型乙型肝炎组13份血清标本HBV cccDNA为阳性,轻度慢性乙型肝炎组仅1份血清标本HBV cccDNA为阳性,血清HBV cccDNA的含量为1.25×103～4.88×104拷贝/mL,两组患者血清HBV cccDNA检出率差异有统计学意义(P=0.0014).血清HBV cccDNA检测诊断重型乙型肝炎患者的灵敏度和特异度分别为41.94%和96.15%.Logistic逐步回归分析显示,血清HBV ccvDNA的检出率与PT有关(X<'2>=7.2192,P=0.0072),而与患者的年龄、性别、血清总HBV DNA、TBil和ALT水平无相关性.结论 部分乙型肝炎患者特别是重型肝炎患者外周血中可以检测出HBV cccDNA,血清HBV cccDNA的检出可作为支持重型乙型肝炎诊断的指标之一.

Detection of hepatitis B virus covalently closed circular DNA in serum of patients with hepatitis B

Objective To determine whether hepatitis B virus (HBV) covalently closed circular DNA (cccDNA) could be detected in serum of patients with hepatitis B and evaluate the related factors and clinical significances. Methods Fifty-seven patients, including 26 with mild chronic hepatitis B (CHB) and 31 with severe hepatitis B (SHB) were enrolled. Prothrombin time (PT), hepatic biochemical indexes, serum markers of hepatitis virus, serum total HBV DNA and HBV cccDNA of every patient were detected after hospitalization. Factors associated with the detection rate of serum HBV cccDNA were analyzed using Logistic stepwise regression. Results Serum HBV cccDNA was detected in 13 patients with SHB and 1 with mild CHB, and serum levels of HBV cccDNA were varying from 1.25 × 103 to 4. 88 × 104 copy/mL. The detection rates were significantly different between the two groups (P=0. 0014). The sensitivity and specificity of SHB diagnose by serum HBV cccDNA detection were 41.94% and 96.15 %, respectively. Logistic regression analysis showed that the detection rate of serum HBV cccDNA was associated with PT (X2 = 7. 2192, P= 0. 0072), while not associated with age, sex, total serum HBV DNA, total bilirubin or alanine aminotransferase (ALT). Conclusion Serum HBV cccDNA could be detected in some of the patients with SHB, whic hmay be considered as one of the diagnostic indexes for SHB,