HBe抗体阳性的乙型肝炎活动与静息HBV X基因变异的对比研究

为研究乙型肝炎病毒（HBV）X基因变异是否与e抗体阳性的HBV感染的不同临床现象相关，对14例e抗体阳性的无症状携带（AsC)及14例e抗体阳性的慢性活动性肝炎（CAH）病人的血清HBV X基因进行了克隆、测序研究。结果显示，14例AsC中，12例（85.7%）X基因上出现核苷酸插入、缺失、点突变，导致X基因编码的框移而提前终止，或提前出现终止密码子，从而使X蛋白被截短；而14例CAH匀编码154个氨基酸的完整的X蛋白，没有出现上述X基因的变异（P＜0.01）。本研究表明，X基因变异所致的X蛋白截短与e抗体阳性肝淡静息的无症状携带临床现象密切相关。

ANALYSIS OF X GENE MUTATIONS IN HEPATITIS B VIRUS GENOME POSITIVE FOR ANTI-HBE BETWEEN ASYMPTOMATIC CARRIER AND PATIENTS WITH CHRONIC ACTIVE HEPATITIS

To elucidate whether the mutations in X region of hepatitis B virus (HBV) might be responsible for the different clinical profiles in cases positive for antibody to hepatitis B e antigen. The nucleotide sequences of X gene regions in serum HBV were examined in 14 asymptomatic carriers (AsC) and 14 chronic active hepatitis (CAH) patients with antibody to hepatitis e antigen. The results showed that 12 of 14 AsCs (85.7%) had insertions, deletions or point mutations in nucleotide sequence of X region resulting in truncation of the X protein by creating frame shift mutation or a new stop codon, whereas no patient with CAH had those X gene mutations( P <0.01). It is concluded that in anti HBe positive HBV carriers, mutations resulting in the truncation of the X protein were the basis of the difference in clinical profiles, and were closely associated with a subsequent decrease in hepatitis activity.