乙型肝炎病毒前C区1896点突变的检测与病毒复制水平关系的探讨

目的分析乙型肝炎病毒(HBV)前C区1896位基因突变与HBV的感染和复制以及血清ALT水平之间的关系. 方法采用酶联免疫吸附试验(ELISA)检测144例不同e系统表达的乙型肝炎患者血清前S2抗原(Pres2Ag)及其抗体(Pres2Ab),应用荧光定量PCR(FQ-PCR)检测HBV-DVA,PCR固相杂交法测定前C区1896变异株前C区1896变异的存在状况,并对ALT结果进行对比分析. 结果前C区1896变异株在HBeAg与抗-HBe阳性标本中的突变检出率分别为3.33%和46.1%,两者差异有显著性(P<0.05),凡前C区1896阳性样本,一般HBeAg阴性,抗-HBe阳性,且HBV-DNA的值很高,与HBeAg( )DNA含量差异无显著性(P>0.05);HBV-DNA阳性标本Pres2Ag阳性率为81.8%;Pres2Ab为零;且ALT异常水平达(105±207) U/L. 结论HBV-DNA的病毒含量,前C区1896变异导致抗HBe阳性以及前S2蛋白的存在与HBV的感染和复制有密切关系;提示由前C区1896变异引起的抗-HBe阳性感染者体内病毒复制更容易引起ALT升高,证实HBV活性复制是肝细胞持续破坏的重要原因.

Relationship Between Detection of HBV Mutation on 1896 at Pre-c Region and Virus Reproduction

OBJECTIVE To analyze the relationship between HBV gene mutation on 1896 at pre c region and infection and reproduction of HBV as well as serum ALT level. METHODS PreS 2Ag and preS 2Ab of 144 cases of hepatitis B patients were detected with ELISA(enzyme linked immunosorbent assay), HBV DNA by FQ PCR, pre C region 1896 mutation strains by PCR solid phase hybridization and results of ALT were comparatively analyzed. RESULTS The detectable rate of mutation of pre C region 1896 mutation strains in the samples of HBeAg and HBeAb was 3.33% and 46.1%, respectively, they had significant difference (P<0.05). Of the positive samples of pre C region 1896, HBeAg were generally negative, HBeAb positive and DNA values of HBV were fairly high, which had no significant difference with that of HBeAg(+) (P>0.05). Pres2Ag positive rate in the samples of HBV DNA (+) was 81.8%, Pres 2Ab was zero, and the values of ALT reached up to (105+207) U/L . CONCLUSIONS Virus content of HBV DNA, caused by pre C region 1896 mutation and the existence of Pre S 2 protein have close relation to the infection and reproduction of HBV. It implies that Pre C region 1896 mutation gives rise to the patients HBeAb(+), in which the reproduction of virus is prone to the elevation of ALT and it confirms that activity reproduction of HBV plays an important role in the continual impairment of hepatic cells.