合并乙型肝炎病毒感染对丙型肝炎病毒核心抗原检测的影响

目的 探讨合并HBV感染对慢性HCV感染者血清丙型肝炎病毒核心抗原(HCVcAg)检出情况的影响. 方法 收集2005年12月-2009年10月慢性丙型肝炎患者和HBV/HCV合并感染者资料,检测血清HCVcAg和HCV RNA,对后者血清进行HBV DNA、HBeAg检测,分析HCVcAg检出率与HBeAg、HBV DNA定量检测的关系.用独立两组多分类的X2检验方法进行统计学分析. 结果 共收集88例慢性丙型肝炎患者和62例HBV/HCV合并感染者资料,血清HCVcAg的检出率分别为72.7％(64/88)和38.7％ (24/62),两者比较,x2= 17.358,P＜0.01,差异有统计学意义.HCV RNA检出率分别为81.8％ (72/88)和53.2％ (33/62),两者比较,x2=20.110,P＜0.01,差异有统计学意义.62例HBV/HCV合并感染者血清中,HBeAg阳性和HBeAg阴性感染者HCVcAg检出率分别为28.6％ (12/42)和60.0％ (12/20),两者比较,x2=5.641,P=0.011,差异有统计学意义.HCV RNA阳性率分别为42.9％ (18/42)和80.0％ (16/20),两者比较,X2=7.547,P＜ 0.01,差异有统计学意义.HBV DNA阳性和阴性时HCVcAg检出率分别为39.1％ (18/46)和37.5％ (6/16),两者比较,P＞0.05,差异无统计学意义.与单纯HCV感染者血清HCVcAg检出率72.7％ (64/88)比较,HBeAg阴性合并感染者为60.0％ (12/20),x2=1.266,P=0.261,差异无统计学意义;HBV DNA阴性合并感染者为37.5％ (6/16),x2=7.635,P＜0.01,差异有统计学意义.结论 HBV/HCV合并感染时HCVcAg检出率较低,可能是由于HBeAg抑制HCV的复制,从而减少HCVcAg的表达所致.

Detection of core antigen of hepatitis virus C in patients infected with hepatitis virus C and B

Objective To observe the effect of hepatitis virus B on the detection rate of core antigen of hepatitis virus C in sera of chronic hepatitis C patients.Method HCVcAg and HCV RNA in sera were detected in 88 patients with chronic hepatitis C and 62 patients co-infected with HCV and HBV.At the same time,HBV DNA and HBeAg in sera were detected in 62 patients infected with HCV and HBV.Then we analyzed the correlation between HCVcAg and HBeAg / HBV DNA.Results The detection rates of HCVcAg in 88 patients with chronic hepatitis C and 62 patients co-infected with HCV and HBV were 72.7％ (64/88) and 38.7％ (24/62),respectively (x2= 17.358,P＜ 0.01).The detection rates of HCV RNA in 88 patients with chronic hepatitis C and 62 patients co-infected with HCV and HBV was 81.8％ (72/88) and 53.2％ (33/62)respectively (x2=20.110,P ＜ 0.01).In 62 patients infected with HCV and HBV,the detection rate of HCVcAg in HBeAg positive patients and HBeAg negative patients were 28.6％ (12/42) and 60％ (12/20),respectively ( x2 =7.547,P = 0.011).Moreover,the positive rates of HBV DNA in HBeAg positive patients and HBeAg negative patients were 42.9％ (18/42) and 80％ (16/20),respectively (P＞ 0.05).The detection rates of HCVcAg in HBV DNA positive patients and HBV DNA negative patients were 39.1％ (18/46) and 37.5％ (6/16),respectively ( x2= 0.013,P=0.908).Compared with the detection rates of HCVcAg in patients only infected with HCV,the detection rate of HCVcAg in HBeAg or HBV DNA negative patients infected with HCV and HBV were 60％ (12/20) (x2 = 1.266,P= 0.261) and 37.5％ (6/16) (x2=7.635,P＜ 0.01),respectively.Conclusion The detection rate of HCVcAg in patients infected with HCV and HBV is relatively low.The reason is possibly that HBeAg inhibits duplication of HCV and decreases the expression of HCVcAg.