HCV合并HBV感染者血清学指标的相关价值研究

目的探讨HCV合并HBV感染者的血清学指标，分析混合感染后的基因型情况并探讨其临床意义。 方法采用ELISA方法对431例丙型肝炎患者进行抗-HCV以及乙型肝炎病毒抗原-抗体的血清学检测，采用化学发光微粒子免疫分析确认，其中HCV感染合并HBV感染者60例作为试验组，HCV感染者60例为对照组。采用实时荧光定量聚合酶链反应（PCR）对60例HCV合并HBV感染的患者血清进行HCV RNA和HBV DNA载量检测，并对HCV和HBV进行基因分型及检测生化指标。 结果试验组与对照组患者病毒载量高于1 × 10⁵拷贝/ml的感染者分别为68.33%（41/60）和31.67%（19/60），差异具有统计学意义（F = 35.35、P = 0.0403）。试验组患者HCV的3个亚型分别为1b 71.67%（43/60）、2a 26.67%（16/60）和6a 1.67%（1/60），HBV分型C、B基因型分别为83.33%（50/60）和41.67%（25/60），差异具有统计学意义（F = 38.15、P = 0.0326）。试验组与对照组的转氨酶升高的阳性率分别为56.67%（34/60）和25.00%（15/60），差异具有统计学意义（F = 40.65，P = 0.0214）。 结论HCV合并HBV感染后HBV基因型以C型为主，感染后抗-HCV水平不受影响。感染的HBV受HCV的抑制。HCV合并HBV感染者可能会增加肝癌发生的风险。

Related research value of serological indexes of HCV complicated with HBV infection

ObjectiveTo explore the serological indexes of HCV complicated with HBV infection, and to explore the clinical significance by analyzing the mixed infection of genotype. MethodsThe levels of anti-HCV and serological test of anti-HBV of 431 cases with HCV infection were tested by ELISA, then the results were confirmed by chemiluminescence immunoassay particles. Total of 60 cases with HCV and HBV co-infection were taken as treatment group, the 60 cases with HCV infection were as control group. The levels of HCV RNA and HBV DNA loads of 60 cases with HCV and HBV co-infection were detected by real-time fluorescence quantitative polymerase chain reaction (PCR), while the genotyping and related biochemical indicators of HCV and HBV were detected, respectively. ResultsAmong the experimental group and the control group, patients with viral load higher than 1 × 10⁵ copies/ml were 68.33% (41/60) and 31.67% (19/60), respectively, with significant difference (F = 35.35, P = 0.0403). The cases in the experimental group of the three subtypes of HCV (1b, 2a and 6a) were 71.67% (43/60), 26.67% (16/60) and 1.67% (1/60), respectively; while the patients with C and B genotypes in HBV subtypes were 83.33% (50/60) and 41.67% (25/60), with significant difference (F = 38.15, P = 0.0326). The positive rates of transaminase increasing were 56.67% (34/60) and 25.00% (15/60) in the experimental group and the control group, with significant difference (F = 40.65, P = 40.65). ConclusionsThe genotype of HBV is mainly C after HCV and HBV co-infection, and the level of anti-HCV level is not affected. HBV infection is inhibited by HCV. HCV and HBV co-infection might increase the risk of hepatocellular carcinoma.