慢性乙型肝炎患者外周血单个核细胞内HBV RNA、HBV DNA的检测及其与血清HBV DNA的关系

目的:探讨慢性乙型肝炎(慢乙肝)患者外周血单个核细胞(PBMC)中HBV感染情况及复制状态,以及与血清HBV DNA的关系.方法:应用PCR技术特异性,选择地检测慢乙肝患者PBMC中HBV RNA、HBV DNA,并与血清HBV DNA进行比较.结果:在慢乙肝患者PBMC中能检测出HBV RNA及HBV DNA,阳性率分别为38.78%及77.55%,且两者的检出率有一致性.当PBMC中HBV RNA阳性时,HBV DNA均为阳性(100%),而当HBV DNA阳性时,部分病例可表现为HBV RNA阴性,两者阳性符合率为50%.血清中HBV DNA阳性率为71.42%.PBMC中HBV RNA的阳性率与血清中HBV DNA的阳性符合率为63.33%,血清中HBV DNA与PBMC中HBV DNA阳性符合率为76.32%.结果提示:HBV能感染PBMC,在部分患者存在着活动性复制,这种复制表现为不同于肝细胞内的低水平复制.此外,HBV感染PBMC后也存在着非复制状态,表现为PBMC中HBV DNA阳性,但HBV RNA阴性.另外,当血中HBV DNA阴性时,少数病例PBMC仍可表现为HBV RNA及HBV DNA阳性.结论:HBV能够感染PBMC并存在活动性复制,可能是造成患者免疫功能紊乱、肝脏损害慢性化的重要原因之一.

Detection of HBV RNA and HBV DNA in Peripheral Blood Mononuclear Cells and Its Relationship with Serum HBV DNA in Chronic Hepatitis B

Objective:To investigate hepatitis B virus (HBV) replication status in peripheral blood mononuclear cells (PBMC) and relationship between HBV RNA and HBV DNA in PBMC with HBV DNA in serum in chronic hepatitis B patients.Methods:Specific detection of HBV RNA and HBV DNA in PBMC using a sensitive PCR assay was taken.Results:HBV RNA and HBV DNA positive rate in PBMC in chronic hepatitis B were 38 78% and 77 55%, respectively. When HBV RNA in PBMC was positive, HBV DNA in PBMC was also positive. However, when HBV RNA was negative, HBV DNA could be positive. Moreover, when HBV DNA in serum was negative, HBV RNA and HBV DNA could be positive in PBMC in some cases of chronic hepatitis B.Conclusion:HBV could present replication as well as non replication in PBMC.The active replication of HBV in PBMC may be the one of important reasons of frequent damage of liver and also disorder of immune system in chronic hepatitis B.