慢性乙肝患者抗病毒治疗前后特异性T细胞免疫观察

目的 了解抗病毒治疗前后慢性乙型肝炎患者特异性T淋巴细胞对HBV抗原蛋白免疫应答的变化及其特征.方法 收集17例慢性乙型肝炎患者抗病毒治疗前及治疗后1个月、3个月的外周血单个核细胞,以HBV特异性抗原蛋白HBsAg、HBcAg和HBeAg为刺激物,酶联免疫斑点法检测其分泌IFN-γ产生斑点的情况.同时对血清HBV DNA和HBsAg、HBeAg等病毒学指标及谷丙转氨酶(ALT)等生化学指标进行榆测并分析其相关性.结果 治疗前,所有患者ALT、总胆红素(TBiL)均高于正常上限,17例患者HBV DNA均大于104拷贝/ml;治疗1个月后,ALT复常率为35.3%,9例患者HBV DNA降为检测下限以下;治疗3个月后,ALT复常率为58.8%,有11例患者HBV DNA降为检测下限以下.抗病毒治疗前、治疗1个月、治疗3个月患者针对HBV特异性蛋白总的T细胞反应阳性率分别为64.7%、76.5%和82.4%,其差别无统计学意义.不论治疗前后,患者对HBeAg的特异性T细胞反应频率和平均反应强度最高;治疗后,对3种蛋白的特异性T细胞反应频率和平均反应强度各有不同程度的增加,其中以对HBcAg蛋白的平均反应强度的增强最明显,治疗前和治疗3个月,治疗1个月和治疗3个月之间的差别都有统计学意义.患者对HBcAg蛋白的特异性T细胞反应平均反应强度与病毒载量有明娃负相关,与血清ALT无明显相关性.结论 本研究结果提示抗病毒治疗后,患者对HBV的特异性T细胞免疫应答有所增强,这种改变可能与HBV DNA的下降有关,检测HBV特异性T细胞反应对丁解患者的免疫状态有重要的意义.

Abstract：

Objective To explore the responses of antigen-specific T cells stimulated by hepatitis B virus(HBV)-specific proteins in chronic hepatitis B patients accepting antiviral therapy. Methods Seventeen patients with chronic hepatitis B (CHB) accepting antiviral therapy were included in this study. The peripheral blood monocular cell ( PBMC) were separated from the whole blood collected at the three different time of before and one and three months after accepting antiviral therapy. ELISPOT assay was used to detect the frequency and strength of secreting IFN-γ cells of PBMC stimulated by HBsAg, HBcAg and HBeAg. HBV virus loading, HBsAg, HBeAg, ALT and AST in serum were detected at the same time. Results After three months therapy, ALT, TBiL were improved in all patients, and HBV DNA level were dropped and undetectable in 11 cases. The rates of T cell response in patients to HBV specific proteins were 64. 7% , 76. 5% and 82. 4% at the time of before and one and three months after accepting antiviral therapy, respectively. The frequency of responses of antigen-specific T cells stimulated by HBcAg was higher than that stimulated by HBsAg or HBeAg, and the frequency was enhanced after antiviral therapy. The average response magnitude was expressed as spot forming cells (SFC) per million input cells. SFC of T cell responses to HBcAg was also higher than to HBsAg or HBeAg. There was no significant difference in SFC of T cell responses to HBsAg or HBeAg at the time of before and after antiviral therapy, but there were significant difference in SFC of T cell responses to HBcAg at the time of before and after antiviral therapy. SFC of T cell responses to HBcAg was negatively associated with HBV DNA, and no associated with level of ALT in serum. Conclusion The responses of antigen-specific T cells were improved in CHB patients accepting antiviral therapy which associated with the decrease of HBV DNA. It suggested to investigate HBV specific T cell responses was important.     

慢性乙型肝炎患者抗病毒治疗前后HBeAg特异性T细胞应答特征研究

目的研究慢性乙型肝炎(CHB)患者抗病毒治疗前后T细胞对HBV特异性抗原蛋白(HBeAg)的免疫应答特征。方法分别收集22例慢性乙型肝炎患者抗病毒治疗前、治疗后3月、6月和12月的外周血,以HBeAg蛋白刺激外周血单个核细胞,采用酶联免疫斑点技术(ELISPOT)检测产生IFN-γ的HBeAg特异性T细胞的频率和强度。结果 1)CHB患者抗病毒治疗前和治疗后3月、6月、12月总的T细胞反应频率分别为31.8%(7/22)、50.0%(11/22)、77.3%(17/22)和95.5%(21/22),治疗后12月反应频率明显高于治疗前和治疗后3月(P0.05),治疗后6月反应频率明显高于治疗前(P0.05),核苷类似物治疗组与干扰素治疗组治疗后T细胞反应频率均无明显差异(P0.05)。2)治疗后12月T细胞的反应强度明显高于治疗前、治疗后3月及治疗后6月(P0.05)。核苷类似物治疗组与干扰素治疗组均分别得出上述相同的结果。3)将患者T细胞的反应强度与HBV DNA载量(取对数值表示)做Spearman秩相关分析,rs=-0.1860,P=0.041,P0.05,认为患者T细胞对HBeAg蛋白的反应强度与HBV DNA载量存在负相关关系。结论 HBeAg可以刺激CHB患者产生特异性T细胞应答,且随着抗病毒治疗时间的延长,患者HBeAg特异性T细胞的应答频率和应答强度均有所增强,且与血清HBV DNA水平呈负相关关系。     

HBsAg携带者母亲及新生儿的细胞遗传学研究

目的探讨乙型肝炎病毒(HBV)感染对HBsAg阳性携带者母亲及所生新生儿的遗传物质损伤情况.方法用常规法培养淋巴细胞,对20例无症状HBsAg携带者母亲和20例正常对照组女性的姐妹染色单体互换(SCE)频率和染色体畸变频率及其新生儿的染色体畸变频率进行了分析.结果 HBsAg携带者的SCE频率明显高于正常对照组,差异高度显著(t=3.170,P<0.01),HBsAg携带者的染色体畸变频率也明显高于正常对照组,差异显著(t=2.319,P<0.05),新生儿的染色体畸变率在两组间则差异不显著(t=0.214,P>0.05).结论 HBV感染可导致HBsAg携带者的遗传物质不稳定,但对新生儿的遗传物质损伤还不明显.     

聚乙二醇干扰素α-2a联合基因重组酵母乙肝疫苗治疗HBeAg阳性CHB的疗效观察

目的 探讨聚乙二醇干扰素α-2a联合基因重组酵母乙肝疫苗治疗HBeAg阳性的慢性乙型肝炎患者疗效.方法 总75例HBeAg阳性慢性乙型肝炎纳入本研究,其中单用聚乙二醇干扰素α-2a治疗的45例（A组）;聚乙二醇干扰素α-2a联合基因重组酵母乙肝疫苗的HBeAg阳性慢性乙肝患者30例（B组）.对比分析两组在治疗0、24、48和72周时ALT、HBsAg水平、HBeAg血清转换率和HBV DNA阴转率的差异.结果 治疗前（0周）时两组患者的年龄、ALT、HBsAg和HBV DNA水平差异均无统计学意义（P＞0.05）,其中联合治疗组（B组）HBeAg水平明显高于对照组（A组）,差异具有统计学意义（P＜0.05）.第24周和48周时,两组患者的ALT、HBsAg水平、HBeAg血清学转换率和HBV DNA阴转率差异并无统计学意义（P＞0.05）.在治疗结束随访至72周时,A、B两组ALT、HBeAg血清转换率和HBsAg水平差异没有统计学意义（P＞0.05）,但B组HBV DNA阴转率高于A组,差异具有统计学意义（P=0.032）.结论 聚乙二醇干扰素α-2a联合基因重组乙肝疫苗治疗HBeAg阳性的慢性乙型肝炎患者可以提高48周治疗结束后72周时的HBV DNA阴转率,但是与HBeAg血清学转换和HBsAg水平降低无关.     

HBsAg携带者成人及儿童的遗传物质损伤的研究

目的探讨乙型肝炎病毒(HBV)感染对HBsAg阳性携带者成人及儿童的遗传物质损伤情况.方法用常规法培养淋巴细胞,对20例无症状HBsAg携带者成人及其8例同为携带者的子女的姐妹染色单体互换(SCE)频率进行了分析.结果 HBsAg携带者成人SCE频率明显高于正常对照组,差异高度显著(t=3.101,P<0.01),其携带者子女的SCE频率亦明显高于正常对照组,差异高度显著(t=3.161,P<0.01).结论 HBV感染可导致HBsAg携带者成人及儿童的遗传物质不稳定.     

PTD-HBcAg融合蛋白经树突状细胞诱导特异性CTL抑制HBV的体外研究

目的:探讨经PTD-HBcAg融合蛋白致敏的树突状细胞(DCs)体外诱导特异性细胞毒T淋巴细胞(CTLs)对HBV的抑制作用.方法:体外分离培养小鼠髓源性DC,加入融合蛋白刺激DC成熟后与T淋巴细胞共培养,ELISA 法检测T淋巴细胞上清中IL-2、IL-4、IL-10和INF-γ的分泌水平,流式细胞术检测胞内细胞因子水平,乳酸脱氢酶释放试验检测特异性CTL活性,并对HepG2.2.15细胞上清中HBsAg及HBV DNA水平进行检测.结果:经不同融合蛋白刺激的DCs能有效促进T淋巴细胞的细胞因子分泌,同时融合蛋白PTD-HBcAg组中IL-2(552.7±117.5 ng/L)和INF-γ(150.6±7.945 ng/L)明显高于HBcAg组中IL-2(420±12.47 ng/L)和INF-γ(107.5±12.19 ng/L)分泌.流式细胞计数术检测的PTD-HBcAg融合蛋白诱导CTL细胞水平明显高于对照组.经PTD-HBcAg融合蛋白诱导的CTL比HBcAg有明显的特异性杀伤作用(P＜0.05),同时对HBsAg及HBV DNA水平有明显的抑制作用.结论:经PTD-HBcAg融合蛋白致敏的DCs能有效刺激T淋巴细胞分泌细胞因子及增加细胞毒T淋巴细胞的表达,并增强特异性CTL活性及对HepG2.2.15细胞上清中HBsAg及HBV DNA水平的抑制.     

乙肝病毒感染与乙肝病毒相关性肾炎间的关系分析

目的 探讨研究乙肝病毒(HBV)感染与乙肝病毒相关性肾炎之间的关系.方法 对124例资料完整的HBV相关肾炎(HBV-related glomerulonephritis,HBV-GN,)患者的血清病毒学、肾脏及肝脏病理学和常规实验室检查结果进行回顾分析研究.结果 124例血清HBsAg和/或HBeAg阳性的患者中,HBV-GN的发生率69.49％,男性发生率(45.0％)显著高于女性(24.49％),P＜0.05.血清HBeAg阳性组HBV-GN的发生率显著高于HBeAg阴性组.HBV DNA定量＞105 copies/mL组HBV-GN的发生率亦显著高于定量＜105 copies/mL组.HBV-GN患者血清HBeAg阳性与阴性组之间比较,24小时尿蛋白定量及内生肌醉清除率均无显著差异.血清HBV DNA定量＞105copies/mL组与定量＜ 105 copies/mL组之间比较24小时尿蛋白定量与内生肌酐清除率亦无显著差异.HBV-GN患者肾组织局部HBcAg沉积阳性组与阴性组相比较,24小时尿蛋白定量有显著性差异(P＜0.05),而内生肌酐清除率无显著性差异.结论 HBV感染及其复制状态与HBV-GN的发生密切相关;但HBV的复制状态可能并不明显影响HBV-GN患者肾、肝组织的病变程度.     

慢性乙肝病毒携带者外周血皮质醇水平与T细胞亚群状态的研究

目的 探讨慢性乙肝病毒(HBV)携带者血浆皮质醇水平与细胞免疫状态的变化.方法 选取符合诊断标准的慢性HBV携带者60例,正常对照10例,放射免疫法测定血浆皮质醇水平,流式细胞仪检测外周血T细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+比例.结果 与正常对照组相比,慢性HBV携带者血浆皮质醇水平相对升高(P＜0.05),CD4+细胞比例无明显变化(P＞0.05),CD8+细胞比例明显增加(P＜0.05),CD4+/CD8+明显下降(P＜0.05).HBeAg阳性组与HBeAg阴性组比较,HBeAg阳性组血浆皮质醇升高较为明显(P＜0.05),CD4+细胞比例无明显变化(P＞0.05).CD8+细胞比例明显增加(P＜0.05),CD4+/CD8+明显下降(P＜0.05).结论 慢性乙肝病毒携带者存在着血浆皮质醇水平的增高及细胞免疫功能的失衡,慢性HBV感染过程中存在内分泌-免疫系统紊乱.     

新生儿静脉血与脐带血及孕妇静脉血HBV病原学标记物相关性研究

目的 探讨慢性HBV感染孕妇所生新生儿脐带血与静脉血HBV标志物状况的一致性和相关性,以及与孕妇HBV感染标志物的相关性.方法 以HBsAg、HBeAg双阳性且HBV DNA＞1 ×105拷贝/ml孕妇及新生儿为研究对象,孕妇分娩前采集静脉血,新生儿于注射乙肝免疫球蛋白、乙肝疫苗前采集静脉血.在清洁和去除脐带表面污染血液,并用酒精消毒后,用注射器采集脐带血.HBsAg、抗HBs、HBeAg、抗HBe采用雅培微粒子化学发光法(美国雅培公司试剂,Abbott Architac i2000)检测,HBV DNA含量经COBAS TagMan HBV DNA定量检测仪检测.结果 共入组孕妇383例及所生新生儿,静脉血和脐带血HBsAg的阳性检出率分别为61.2％和63.9％,HBeAg阳性检出率分别为83.2％和83.5％,HBV DNA阳性检出率分别为56.0％和59.4％,静脉血和脐带血之间均有一致性.静脉血和脐带血间HBsAg、HBeAg和HBV DNA含量的相关性具有统计学意义(r=0.766、0.857、0.692,P＜0.000).新生儿静脉血和脐带血的HBeAg含量与孕妇的HBeAg含量具有相关性(r=0.362,P=0.000;r=0.352,P=0.000),而静脉血和脐带血的HBsAg含量与孕妇血清的HBsAg含量无相关性(r=0.023,P=0.785;r=0.04,P=0.604).结论 慢性HBV感染孕妇所生新生儿脐带血和静脉血HBV标志物状态有良好的一致性,可以以脐带血的HBV标志物反映新生儿静脉血HBV标志物.     

HBV体外感染卵巢颗粒细胞

目的建立HBV体外感染颗粒细胞模型,研究HBV在颗粒细胞中的复制情况,为深入研究HBV经卵细胞母婴垂直传播提供研究平台。方法原代颗粒细胞体外培养后用HBV阳性血清感染。收集培养上清,在不同时点检测HBsAg、HBeAg定量,实时定量PCR检测HBVDNA。免疫组化检测培养细胞中的HBsAg和HBcAg。巢式PCR检测细胞中的HBVDNA及HBV-mRNA。原位杂交检测细胞内的HBVDNA。结果成功建立了HBV体外感染颗粒细胞模型,在培养上清中可以持续96h检测到HBsAg和HBV DNA,在细胞内检测到HBsAg和HBcAg的阳性信号,PCR扩增显示细胞内有HBVD-NA及HBV-mRNA的存在,原位杂交证实细胞内HBVDNA阳性。结论 HBV能够在体外感染颗粒细胞,并在其内复制,该结果为深入研究HBV经卵细胞传播机制提供了很好的研究平台。     

乙型肝炎病毒C启动子区C1673T/C1799G联合突变的意义

目的 探讨HBV(乙型肝炎病毒)C启动子区(CP) C1673T/C1799G联合变异的生物学和临床意义.方法 136名慢性HBV感染者,包括无症状携带者(ASC) 25例,慢性乙型肝炎(CHB)38例,慢性重型乙型肝炎(CSHB) 24例,乙肝肝硬化(LC) 36例,肝细胞肝癌(HCC)13例,用半巢氏PCR的方法结合直接测序法检测HBV基因亚型及CP区变异,分析C1673T/C1799G联合变异在不同基因亚型中的发生率及与HBV复制、e抗原表达和不同慢性HBV感染疾病谱的关系.结果 本组病例中,Ba亚型110例,Bj亚型1例,C1亚型7例,C2亚型8例,C1673T/C1799G联合变异发生率为80.9％,其中在Ba亚型中为96.4％,C1亚型为14.3％,C2亚型为12.5％,Ba亚型与C1和C2亚型比较,差异有统计学意义(P ＜0.0001).变异组HBV DNA载量与非变异组比较差异无统计学意义(P＞0.05);e抗原阳性组变异率为71.4％,e抗原阴性组为87.5％,两组比较差异有统计学意义(P＜0.05).从ASC、CHB、CSHB、LC到HCC组,变异的发生率差异无统计学意义(P＞0.05).结论 C1673T/C17991G联合变异常见于Ba基因亚型,该变异不影响HBV DNA的复制水平,可能与不同慢性HBV感染疾病谱无关.     

肝组织病理及肝内抗原表达与聚乙二醇干扰素α-2a抗乙肝病毒疗效关系的研究

目的观察聚乙二醇干扰素α-2a（PegIFNα-2a）治疗慢性乙型肝炎的疗效,探讨肝脏病理改变和肝细胞内病毒抗原的表达类型与PegIFNα-2a抗病毒疗效的关系。方法选择HBeAg阳性慢性乙型肝炎68例,HBeAg阴性慢性乙型肝炎45例,通过肝组织病理检测,观察肝脏病理改变和肝细胞内病毒抗原的表达类型与PegIFNα-2a治疗后血清HBV DNA的阴转率、HBeAg转换率和完全应答率之间的关系,并随访48周,观察持续应答情况。结果 HBsAg的阴转在不同的炎症活动度间差异无统计学意义;在HBeAg阳性患者中,G1组的HBeAg转换率和完全应答率与G3组比较差异有统计学意义（P均〈0.05）;炎症活动度高的病例经治疗后48周的持续应答率高于炎症活动度低的病例（χ2=4.311,P〈0.05）;肝细胞内HBcAg浆型表达者HBeAg阴转、HBeAg转换率、HBV DNA的阴转率均高于HBcAg核型表达者（P均〈0.05）。结论肝组织病理改变和病毒抗原在肝细胞的表达类型可能成为PegIFNα-2a抗病毒疗效的潜在预测因素。炎症活动度高、肝细胞内HBcAg浆型表达者可能对PegIFNα-2a的治疗应答更好。     

Characterization of Full-Length Genomes of Hepatitis B Virus Quasispecies in Sera of Patients at Different Phases of Infection

Hepatitis B virus (HBV) infection results in different clinical presentation due to different levels of immune response. Our study aimed to characterize HBV full-length genome quasispecies (QS) in patients with different phases of infection to better understand its pathogenesis. Forty treatment-naive HBV-infected patients were enrolled, including 10 cases of acute hepatitis B (AHB), 9 cases of immunotolerant (IT) HBV carriers, 11 cases of chronic hepatitis B (CHB), and 10 cases of acute-on-chronic liver failure (ACLF). The present study was conducted by clone-based sequencing. QS heterogeneity within each open reading frame was calculated. The mutation frequency index (MFI) and amino acid variations within the large HBsAg, HBcAg, and HBxAg regions were analyzed based on the different infection phases. In total, 606 HBV full-length sequences were obtained. HBV QS had higher heterogeneity in ACLF and CHB than that in IT among chronically infected individuals. AHB patients had the lower QS heterogeneity at onset than those with chronic infection. ACLF patients had the highest frequency of mutations in the core promoter and precore region. A triple mutation (A1762T/G1764A/G1896A) was observed more frequently in genotype C than in genotype B. The MFI indicated that specific peptides of the studied regions had more frequent mutations in ACLF. Furthermore, several amino acid variations, known as T- and B-cell epitopes, were potentially associated with the immunoactive phase of infection. More HBV genome mutations and deletions were observed in patients with more severe diseases, particularly in specific regions of the core and preS regions, the clinical significance and mechanism of which need to be further investigated.     

HBV感染对FibroScan（R）实施受控衰减参数评价脂肪肝影响的研究

目的 评价HBV感染是否对FibroScan（R）实施受控衰减参数（CAP）有影响.方法 使用FibroScan-502机型对临床诊断非酒精性脂肪性肝病（NAFLD）患者、慢性乙型肝炎患者（CHB）及慢性乙肝合并脂肪肝（CHB合并NAFLD）患者进行肝脏脂肪含量（CAP值）测定.结果 579例CHB患者、124例CHB合并NAFLD患者和624例NAFLD患者FibroScan检查,FibroScan测定的CAP与BMI呈正相关（r=0.46,P=0.004）,而与血清HBV NDA载量、HBsAg载量以及HBeAg阳性与否无关;CHB组的CAP值（218.90 ＆#177;56.40 dB/m）显著低于NAFLD组（290.85＆#177;61.46 dB/m,P=0.00）,也低于CHB合并NAFLD组（284.93＆#177;64.70 dB/m,P=0.00）,而CHB合并NAFLD组的CAP值与NAFLD组间的差异无统计学意义（P=0.55）;血清高HBV DNA载量组的CAP值与低HBV DNA载量组间,高HBsAg载量的CAP值与低HBsAg载量组间,以及HBeAg阳性组的CAP值与HBeAg阴性组间差异均无统计学意义.结论 HBV感染不影响FibroScan测定的CAP值.     

Increased Th17 cells and interleukin-17 contribute to immune activation and disease aggravation in patients with chronic hepatitis B virus infection

T helper17 (Th17) cells have been demonstrated to participate in the pathogenesis of hepatitis B virus (HBV) associated liver damage. However, the contribution of Th17 cells to immune activation and disease aggravation in patients with HBV infection is not fully clear. In this study, we investigated the Th17 cells frequencies and interleukin-17 (IL-17) mRNA expressions in peripheral blood mononuclear cells (PBMCs), intrahepatic IL-17-positive cells accumulation, as well as serum IL-17 levels in asymptomatic chronic HBV carriers (AsC), and patients with chronic hepatitis B (CHB) and HBV related acute-on-chronic liver failure (ACLF). Furthermore, the dynamic changes of Th17 cells frequencies and IL-17 concentration in different prognostic ACLF patients were observed. As result, the intrahepatic and peripheral Th17 cells and serum IL-17 concentration were both significantly higher in CHB and HBV related ACLF patients than that in AsC and normal control groups, and increased gradually with immune inflammation aggravation from AsC, CHB to ACLF. Moreover, in ACLF patients, peripheral Th17 cells frequencies were positively correlated with international normalized ratio (INR) and model of end-stage liver disease (MELD) score. Especially the survival patients had an initially lower Th17 cells frequencies and IL-17 levels which gradually decreased following condition improvement as compared with higher baseline level followed by gradually increasing trend in the non-survivals. In conclusion, Th17 cells can be contributed to the immune activation and disease aggravation in patients with chronic HBV infection. This may places Th17 cells as a potential blocking target for controlling CHB and ACLF.     

Association of cytokines with hepatitis B virus and its antigen

To investigate the characteristics of cytokines in patients with different HBV infection status and their correlation with HBV DNA, HBsAg, and HBeAg levels. Peripheral blood samples were collected from patients with chronic HBV infection in immune tolerance phase (IT), HBeAg-positive chronic hepatitis B (CHB), and acute hepatitis B (AHB) groups, and levels of cytokines were detected by Luminex technique, and analyzed by FLEXMAP 3D analyzer. The correlation between cytokines and HBV DNA load, HBsAg, HBeAg, and alanine aminotransferase (ALT) level in patients with chronic HBV infection was analyzed. In total 312 subjects (184 males and 128 females) were enrolled in the study. There were significant differences among IT, CHB, and AHB groups in Flt-3L value (P = .003; H = 12.312), IFN-γ (P = .001; H = 11.723), IL-10 (P = .001; H = 18.736), IL-17A ((P = .001; H = 12.735), and TGF-β1 (P = .001; Z = 48.571). IFN-α2 levels in CHB group were significantly higher than those in IT and AHB groups (15.24 vs 35.78 pg/mL, P = .000; Z = 3.727; 13.88 vs 35.78 pg/mL, P = .024; Z = −2.258. In CHB group, the levels of HBsAg and ALT were positively correlated with the levels of IL-10 (r = .173; P = .006; r = 0.176; P = .006, respectively), while HBeAg level was positively correlated with the IFN-α2 level (r = .153; P = .016). In AHB group, the HBsAg level was positively correlated with Flt-3L, IFN-α2, IL-10, and IL-6 (r = .402; P = .023; r = .436; P = .016; r = .524, P = .002; r = .405; P = .022, respectively). HBeAg level was positively correlated with IFN-γ and IL-17A levels (r = .400; P = .023; r = .373; P = .036, respectively), and ALT level was positively correlated with IL-6 levels (r = .367; P = .039). In either AHB or CHB group, HBV DNA load was only related to TGF-β level (r = .493; P = .004; r = −.218, P = 0.009 respectively). The correlation between Flt-3L and HBsAg (F = 7.422; P = .007); IL-17, IL-6, and HBeAg (F = 5.757; P = .017; F = 6.156; P = .014) were statistically significant. There was significant correlation between TGF-β2 and HBV DNA (F = 11.795; P = .001), and between ALT and HBsAg, HBV DNA (F = 26.089; P = .000; F = 4.724; P = .031). HBsAg, HBeAg, and HBV DNA were correlated with cytokines and ALT in patients with HBV infection. The level of IFN-α2 was significantly higher in patients with CHB. HBV DNA load was only correlated with the level of TGF-β in acute or CHB.     

广州市从业人员HBV及ALT检测结果分析

目的了解广州市从业人员乙型肝炎病毒（HBV）及丙氨酸氨基转移酶（ALT）的检测情况,为制定防控措施提供科学依据。方法对2009年在广州市疾病预防控制中心健康体检的从业人员的血清标本进行乙型肝炎病毒表面抗原（HBsAg）、乙型肝炎病毒e抗原（HBeAg）、ALT检测。结果从业人员的HBsAg阳性率为4.51%（10368/229738）,HBeAg阳性率为1.30%（2998/229738）,ALT异常率为0.92%（2125/229738）;30～岁组HBsAg阳性率最高（5.15%）,〈30岁组HBeAg阳性率最高（1.61%）;不同年龄组间的HBsAg和HBeAg阳性率比较差异有统计学意义（P〈0.001）;男性的HBsAg、HBeAg阳性率及ALT异常率比女性高,差异均有统计学意义（P〈0.001）。结论广州市从业人员HBV感染状况较我国一般人群携带率低,实行预防性健康体检、健康教育和疫苗接种等措施可逐步降低HBV感染。