乙型肝炎病毒核心基因启动子变异对HBeAg表达及病情的影响

目的:研究乙型肝炎病毒核心基因启动子(HBVBCP)变异对HBeAg表达及病情的影响。方法:采用PCR微板核酸杂交结合ELISA检测显示技术,对176例HBV慢性感染者血清进行检测HBVBCP区核苷酸(nt)1762碱基A→T和1764G→A联合突变。采用ELISA检测技术,检测患者血清HBV标志物。结果:在176例HBV慢性感染者中检出HBVBCP区T1762A1764G变异者73例,HBVBCP变异的阳性率为41.5%,HBVBCP变异在HBeAg阴性病例的阳性率为49.4%,显著高于HBeAg阳性病例的阳性率33.3%。HBVBCP双变异在慢性乙型肝炎轻、中、重度组,肝炎肝硬化组,慢性重症肝炎组和原发性肝癌组的阳性率分别为28.0%、31.4%、34.2%、39.4%、60.0%和70.0%。各型肝病与HBVBCP变异的阳性或阴性进行相关分析,结果有显著性差异。结论:本组病例HBVBCP变异的阳性率为41.5%,变异可引起HBV感染者的HBeAg阴转。HBVBCP变异与HBV慢性感染的临床类型呈正相关,随着病情加重,BCP变异的阳性率有增高趋势。

The effects of mutations in the core promoter gene of hepatitis B virus on serum e antigen and the severity of chronic hepatitis B

Objective: To investigate the effects of mutations in the core promoter gene of hepatitis B virus on serum e antigen and the severity of chronic hepatitis B. Methods: (1)Project subject: 176 patients with chronic hepatitis B virus infection were studied. (2) Project methods: ① The A to T mutation at nucleotide 1762 and G to A mutation at nucleotide 1764 were determined by the method of polymerase chain reaction (PCR) microplate hybridization ELISA in these patients. ② Serum HBV markers were determined by ELISA. Results: (1) The T1762 and A1764 mutants in HBV BCP region were found in 73 patients of hepatitis B virus-related chronic liver disease. The positive rate of HBV BCP mutants was 41.5%. The rate of HBV BCP mutants in negative and positive groups of HBeAg was 49.4% and 33.3% respectively. (2) The positive rate of HBV BCP mutants in mild , moderate and sever, chronic hepatitis B,liver cirrhosis, chronic fulminant hepatitis and HCC were 28.0 %,31.4 %,34.2%,39.4%,60.0% and 70.0 % respectively.There were positively correlations between HBV BCP mutants and the progression of HBV-related liver disease. Conclusion: (1) The T1762 and A1764 mutants in HBV BCP region could lead to the negative of HBeAg.(2) The positive rate of HBV BCP mutants was associated with the development of progressive liver diseases.