乙型肝炎患者重叠感染HCV及HDV临床意义探讨

本文对305例乙型肝炎患者的血清标本回顾性地检测了HCV及HDV感染标志,结果有48.2％的乙肝患者重叠感染了HCV和/或HDV,其中双重感染率:HBV/HCV 15.4％,HBV/HDV 21.0％;三重感染率:HBV/HCV/HDV同时感染占11.8％,急性盱炎(AH)、厄症状表面抗原携带者(ASC),慢迁肝(CPH).慢活肝(CAH)、肝硬化(CIR)、重型肝炎(SH)及原发性肝癌(PHC)患者的抗-HCV检出率分别为:6.7％、6.7％、22.5％.29.7％、36.4％、38.5％、33.3％:其DHV的检出率分别为:10.0％、13.3％、25.0％、35.9％、41.1％、53.8％、42.9％。肝病越严重,其HCV及HDV的感染率就越高,提示HBV重叠感染HCV及HDV时可以促使肝脏病变加重。合并HCV及HDV感染者的HBV复制率较低。

Clinical Significance of Superinfection with HCV and HDV in Patients with Viral Hepatitis B

We tried to investigate the clinical significance of superinefection with HCV and HDVin patients with viral hepatitis B. Methods: HCV and HDV markers were determined in 305 patients with viral hepatitis B(HB). Results: The total positivity rate of superinfection with HCV and/or HDV in these patients was 48.2%, of which double infection of HBV/HDV was 15.4%, HBV/HDV 21.0%; three-fold infection of HBV/HCV/HDV 11.8%. The prevalences of HCV markers in acute hepatitis, asymptomatic HBsAg carriers, chronic persistent hepatitis, chronic active hepatitis, hepatic cirrhosis, severe hepatitis and primary hepatocellualar carcinoma were 6.7%, 6.7%. 22.5%, 29.7%. 36.4%, 38.5%, 33.3% and that of HDV markers were 10.0%. 13.3%. 25.0%, 35.9%. 41.1%. 53,8%. 42.9% respectively. The severer the HB, the higher the HCV and HDV positivity rate. Conclusion: The superinfection of HCV or HDV with HBV will result in worsening of the hepatopathy. The incidence of hepatitis B viral replication marker was found lower in patients with co-infectoin of HBV and HCV and or HDV than that in those without co-infection.