乙型肝炎病毒cccDNA定量与乙型肝炎临床及病理关系

目的探讨慢性乙型肝炎（CHB）肝组织HBVcccDNA定量与乙型肝炎的关系。方法分别采用荧光定量PCR、酶联免疫吸附分析法（ELISA）检测48例CHB肝组织HBVcccDNA定量、肝组织和血清HB VDNA定量、乙型肝炎病毒标志物。同时用链霉菌抗生素蛋白-过氧化物酶连接法（SP）检测肝细胞中HBcAg表达。分析肝组织HBVcccDNA与组织和血清HBV DNA、HBeAg、肝细胞内HBcAg水平及肝脏炎症活动度的关系.结果1．肝组织HBVcccDNA定量与组织和血清HBV DNA定量呈正相关（r=0．837，P〈0．001；r=0．627，P〈0．005）；2．肝组织HBV cccDNA定量与肝细胞内HBcAg半定量呈正相关（r=0．618，P〈0．005）；3．肝组织HBV cccDNA定量与肝脏炎症活动度尤明显相关（P〉0．05）：4．HBeAg阳性较抗-HBe阳性患者肝组织HBV cccDNA定量、肝组织和血清HBV DNA定量高（P〈0．05）。结论荧光定量PCR法检测肝组织HBV cccDNA定量是评价HBV复制最直接可靠的指标，在CHB的诊断和抗病毒治疗中有重要意义。但与肝组织炎症无明显相关。

Clinical and pathological relationship between the quantity of hepatitis B virus covalently closed circular DNA and chronic hepatitis B

Objective To study the clinical and pathological relationship between the quantitation of HBV cccDNA and chronic hepatitis B(CHB).Methods Quantitative PCR were used to detect HBV cccDNA in liver biopsies.The same method was used to examine HBV DNA in sera and liver biopsies.ELISA(Enzyme-Linked Immunosorbent Assay) was used to detect hepatitis B serum markers.Expression of HBcAg in liver tissue was detected by using SP method.Results 1.There was a strong correlation between the cccDNA levels in the biopsy samples and HBV DNA levels in the sera and liver biopsies.2.There was a significant correlation between cccDNA copy number and the number of HBcAg cells in liver tissue.3.The correlation between quantitation of cccDNA in liver biopsies and histological activity index was not found.4.HBeAg-positive patients had higher HBV cccDNA in liver tissue,and HBV DNA in serum and liver tissue compared with anti-HBe-positive patients.Conclusion Quantitation of HBV cccDNA by real-time fluorescence PCR is a sensitive,stable,and reliable marker to assess HBV replication.And it plays a significant role in the diagnosis and treatment of CHB.But it has no obvious correlation with the liver inflammation.