重型肝炎血清HBV前C区A83变异株比率的动态观察

目的 了解ＨＢＶ前区Ｃ区Ａ８３变异与重型肝炎的关系。方法 用套式错配ＰＣＲ限制片段长度多态性分析和凝胶光密度图象分析仪及定量ＰＣＲ，对９例重型肝炎患者血清ＨＢＶ变异株的比率和ＨＢＶ ＤＮＡ含量进行测定和动态观察。结果 Ａ８３变异株在６例阳性率中均与野生株呈混合感染，其比率〉５０．０％的仅２例，存活死亡各１例，〈３１．０％的４例均死亡，变异株的出现及其比率变化与ＨＢＣＶ ＤＮＡ含量的消长一致，但无统

The percentage of hepatitis B virus precore A83 mutant and its dynamic change in fulminant hepatitis B

Objective In order to clarify whether hepatitis B virus precore A83 mutant is related to the pathogen- esis of fulminant hepatitis B or not. Methods The percentage of hepatitis B virus precore A83 mutant and the quantity of HBV DNA in sera from 9 patients with fulminant hepatitis B were assayed by the method of densitometry after mispairing PCR-restriction fragment length polymorphism (mpPCR-RFLP) and quantitative PCR, respectively. Results The HBV precore A83 mutant was found in sera of 6 out of 9(66.7%) fulminant hepatitis patients while none of them were infected with the mutant strain alone, and all were mixed with wild strain. The percentage of the mutant over fifty percent is only in 2 cases in whom one was 59.3%(survival) and another 64.8%(died). The percentage below 31.0% was in 4 cases and all of them died. It was observed that appearance or disappearance of the A83 mutant and its dynamic change of percentage were consistent with the fluctuation of HBV DNA level but there was no correlation statistically(r = 0.602, 0.583; P > 0.05). Con- clusion The mutant strain alone has little correlation to the occurrence of fulminant hepatitis. It might be merely a accom- paniment to follow the replication of HBV under the highly immune pressure.