某艾滋病治疗示范区人免疫缺陷病毒感染者合并隐匿性乙型肝炎病毒感染的调查分析

目的 调查分析某艾滋病治疗示范区人免疫缺陷病毒（HIV）-1感染者中隐匿性乙型肝炎病毒（HBV）感染的情况及其影响因素.方法 采集某艾滋病治疗示范区97例经血感染HIV-1的感染者的血浆,采用酶联免疫吸附试验（ELISA）检测乙型肝炎表面抗原与抗体（HBsAg与抗HBs）、乙型肝炎e抗原与抗体（HBeAg与抗Hbe）、乙型肝炎核心抗体（抗HBc）及丙型肝炎抗体（抗HCV）;采用吸附柱法抽提HBV DNA;采用巢式聚合酶链反应（PCR）法检测HBV S区;采用流式细胞仪计数CD4＋T淋巴细胞.HBsAg阴性PCR阳性结果 者为合并隐匿性HBV感染者.合并隐匿性HBV感染者为实验组,未合并隐匿性HBV感染者为对照组.结果 97例HIV感染者中HBsAg阴性者92例（94.85%）.92例HBsAg阴性者中合并隐匿性HBV感染者27例（29.35%）,抗HCV阳性者73例（79.35%）.合并隐匿性HBV感染者和未合并HBV感染者CD4＋T淋巴细胞数、单独抗HBc阳性率分别为（212.11±133.1）和（318.9±172.2）cells/mm3、62.96%和18.46%,以上两指标两组比较差异均有统计学意义（P＜0.01）,两组间年龄、性别、是否合并HCV感染及抗HBs阳性率比较差异无统计学意义（P＞0.05）.结论 经有偿献血途径感染HIV者中存在隐匿性HBV感染;HIV阳性合并隐匿性HBV感染者中易出现单纯抗HBc阳性;CD4＋T淋巴细胞数低的HIV感染者更容易合并隐匿性HBV感染.

A cross-sectional survey of occult hepatitis B virus infection in HIV-infected patients in acquired immune deficiency syndrome area

Objective To assess the prevalence of occult HBV infection in HIV-infected patients inacquired immune deficiency syndrome area. Methods Serum samples were obtained from 97 HIV-infected patients who transmitted by paid blood donation. ELISA was used to detect HBV erologic markers (HBsAg, Anti-HBs, HBeAg, anti-HBe and anti-HBc) and HCV antibody. Flow Cytometry were used to detect CD4 +T cell count. Nested PCR was used to amplify surface protein region of HBV DNA. Results Ninety two patients were HBsAg negative in the 97 HIV-infected patients(94. 85% ). Twenty seven patients were co-infected with occult hepatitis B virus infection in the 92 HBsAg negative patients (29. 35% ).Seventy three patients were co-infected with HCV in the 92 HBsAg negative patients(79.35% ). CD4 cell count of subjects with occult HBV infection were significantly lower (212. 11 ± 133. 1 cells/mm3 versus 318.9 ± 172.2 cells/mm3, respectively, P ＜0. 01 ). A significantly higher prevalence of isolated anti-HBc was observed in HIV-infected subjects co-infectionded with occult HBV infection 62. 96% ( 13 of 27 )versus 18.46% (15 of 65 ) , P ＜ 0. 01]. No statistical significant association could be established between the age, sex and whether co-infected with HCV. Conclusion It is found that occult HBV infection did occurs in HIV-infected patients. Individuals co-infected with HIV and occult HBV infection are more likely to have isolated anti-HBc than subjects with HIV alone. Co-infection with HIV and occult HBV is more