晚期血吸虫病患者乙型肝炎病毒DNA的检测及其意义

３１例晚期血吸虫病患者血清及肝组织乙型肝炎病毒ＤＮＡ（ＨＢＶ－ＤＮＡ）阳性率分别为９．７％及１９．４％低于血清及肝组织乙型肝炎病毒表面抗原（ＨＢｓＡｇ）检出率（分别为２９％及４８．４％），ＨＢＶ－ＤＮＡ阳性者病死率高（６６．６％），且死亡与肝病直接相关（肝衰竭及原发性肝癌）。ＨＢＶ－ＤＮＡ阴性患者病死率较低（１２％），其死亡与肝病无直接关系。结果提示，检测晚期血吸虫病患者ＨＢＶ－ＤＮＡ有重要意义。抗乙型肝炎病毒治疗对改善存在ＨＢＶ复制的晚期血吸虫病患者预后可能有重要作用，在血吸虫病疫区普及乙肝疫苗接种将对血吸虫病防治工作产生重大效益。

THE DETECTION AND SIGNIFICANCE OF HBV-DNA IN SERUM AND LIVER OF AD-VANCEDSCHISTOSOMIASIS PATIENTS

Hepatitis B virus deoxyribonucleic acid (HBV-DNA) and surface antigen(HBsAg)in the serum and liver specimens from 31 patients with advanced schistosomiasis were investigated. The patients have been followed up for six years. The presence of HBsAg and HBcAb in serum among patients with ad-vanced schistosomiasis were significantly more frequent than that in the control group(P<0.05), but the prevalence of HBV-DNA and HBeAg in the patients were not significantly different from that in the controls(P>0.05).The positive rate of HBV-DNA and HBsAg in liver was 19.4% and 48. 4% respectively,which were greater than that in serum. The presence of HBV-DNA in patients with ad-vanced schistosomiasis was associated with high mortality and the cause of death was either hepatic failure or hepatocellular carcinoma. The results suggest that it isimportant to detect HBV-DNA both in surum and liver,Antiviral therapy for patients with advanced schistosomiasis who had detectable HBV-DNA may improve the prognosis.