乙型肝炎病毒载量与抗原抗体模式的关系

目的探讨乙型肝炎病毒载量与抗原抗体模式的关系,为乙型肝炎的诊治、预防提供科学依据. 方法用实时荧光定量聚合酶链反应和ELISA检测HBV DNA和抗原抗体,统计分析不同抗原抗体模式的HBV DNA量. 结果在HBsAg和HBeAg阳性模式中,HBV DNA拷贝数＞103/ml者占87.3%,其中＞107/ml者占66.7%;在HBsAg阳性,抗-HBe阳性模式中,HBV DNA拷贝数＜103/ml者占74.5%,＞107/ml者占8.3%;在HBsAg阳性,抗-HBc阳性模式中,HBV DNA拷贝数＞103/ml者占48.0%,＞107/ml者占29.1%.HBeAg阳性模式HBV 载量显著高于HBeAg阴性模式(P＜0.01).抗-HBe阴性模式HBV载量显著高于抗-HBe阳性模式(P＜0.01).在HBsAg阴性模式中,HBV DNA拷贝数＞103/ml占7.9%,1例拷贝数高达1.59×109/ml. 结论 HBeAg阳性模式HBV 载量显著高于HBeAg阴性模式,抗-HBe 阴性模式病毒载量显著高于抗-HBe阳性模式,HBeAg阳性模式中的少数人HBV载量很低,HBeAg阴性模式中少数人HBV载量很高,HBsAg阴性模式中少数人存在病毒复制,因此,对于一具体患者来说,根据抗原抗体模式,难以准确地判断病毒复制程度及其传染性的强弱.

Relationship between the quantities of virus and the models of serologic markers in patients infected with HBV

OBJECTIVE: To explore the relationship between the quantities of HBV and the models of serologic markers. METHODS: Real-time fluorescent quantitative PCR was used to measure the HBV DNA and ELISA was used to detect the antigen/antibody of HBV. RESULTS: The patients whose HBV copies were more than 10(3)/ml accounted for 87.3%, whose copies were more than 10(7)/ml accounted for 66.7% among the HBsAg and HBeAg -positive patients. The patients whose HBV copies were less than 10(3)/ml accounted for 74.5%, whose HBV copies were more than 10(7)/ml accounted for 8.3% among the HBeAg-negative patients. The HBV copies of HBeAg-positive patients were significantly more than HBeAg-negative patients (P<0.01). The HBV copies of anti-HBe-negative patients were significantly more than anti-HBe-positive patients (P<0.01). The HBV DNA was detected in some HBsAg-negative patients. One patient's HBV copies were as high as 1.59 10(9)/ml. CONCLUSIONS: The HBV copies of HBeAg-positive patients are significantly more than HBeAg-negative patients, The HBV copies of anti-HBe-negative patients are significantly more than the anti-HBe-positive patients. However, some HBeAg-positive patient's HBV copies are very low, and some HBeAg-negative patient's HBV copies are very high. HBV DNA even could be detected in some HBsAg-negative patients. It is difficult to judge accurately the quantities of HBV and infectivity according to the serologic markers for a specific patient.