乙型肝炎患者血清HBV前C区A1896变异的检测分析

目的了解HBsAg(+)/HBcAb(+)/HBeAb(+)的慢性乙肝病人血清乙肝病毒(HBV)DNA前C区A1896的变异情况及其与临床关系。方法对所有试验对象检测肝功能指标,根据检测结果分为丙氨酸氨基转移酶(ALT)升高组和ALT正常组。用聚合酶链反应杂交(PCR-ELISA)定量检测HBV-DNA并进一步检测HBV前C区A1896位点的变异情况。结果 38例患者中有18例HBV-DNA阳性,其中15例发生A1896位点变异,变异率为83.3%(15/18)。ALT升高组的18例中,血清HBV-DNA阳性13例,阳性率72.2%,平均浓度为9.62×106(1.10×103～1.09×108)拷贝/ml,A1896变异13例,变异率为100%(13/13)。ALT正常组的20例中,HBV-DNA阳性5例,阳性率25.00%,平均浓度2.55×104(3.28×103～4.61×104)拷贝/ml。A1896变异2例,变异率为40%(2/5)。两组比较无论在HBV-DNA阳性率,还是A1896位变异率都具有统计学差异(P<0.05)。结论 HBsAg(+)/HBcAb(+)/HBeAb(+)的慢性乙肝患者存在较高的A1896变异率,ALT升高组HBV-DNA阳性率和变异率均高于ALT正常组(P<0.05),提示HBV A1896位点变异与肝脏病变活动加重和ALT升高有关。

Analysis on detection of serum HBV preC 1896 mutant in Hepatitis B Patients

Objective To study chronic hepatitis B with HBsAg(+)/HBcAb(+)/HBeAb(+) hapatitis B virus(HBV) precore region mutations at nucleartide A1896 and to develop the relationship between the results and the clinical relevance. Methods To test the patients' liver function and divided the patients into two groups according to the results.The groupⅠpatients' aminotransferase(ALT) was higher than normal range and another group is normal range.HBV DNA was amplified by polymerase chain reaction(PCR),and study the mutation at A1896 further. Results 18 cases HBV DNA was positive in 38 patients.Mutation at nt-1896 was found in 15 patients,the mutation rate was 83.3%.13 cases of 18 in group Ⅰwere HBV DNA positive,the mutation rate was 72.2%,the average of HBV DNA concentration was 9.62×106(1.10×103-1.09×108) copies/ml,all of them had a mutation at A1896,the mutation rate was 100%(13/13).5 cases of 20 in group Ⅱ were DNA positive,the mutation rate was 25.00%,the average of HBV DNA concentration was 2.55×104(3.28×103-4.61×104) copies/ml,two of them had a mutation at A1896,the mutation rate was 40%(2/5).There were statistic differences between two groups in HBV DNA positive rate and A1896 aberration rate(P<0.05). Conclusion The patients of chronic hapatitis B with HBsAg(+)/ HBcAb(+)/ HBeAb(+) had a high mutation rate at A1896.The ALT was higher in patients who had a mutation than those did not(P<0.05).It suggests that the mutation at A1896 was related to liver pathological activity and raised ALT.