HBsAg阴性患者HBV隐匿性感染:110例临床分析

发布时间：2018-05-16 00:10

本文选题：肝炎病毒 + 乙型　；参考：《解放军医学杂志》2015年02期

【摘要】：目的分析隐匿性乙型肝炎病毒感染(OBI)患者的临床特征。方法纳入2012年3月—2014年1月于重庆医科大学就诊的HBs Ag阴性、HBV DNA在检测值以下的乙肝患者110例。采用高纯度病毒核酸检测试剂盒提取血清HBV DNA,采用巢式PCR对HBV基因组C、S、X区进行扩增。对不同性别、年龄及血清学模式[单独抗-HBc(+)及抗-HBs(+)/抗-HBc(±)]患者,以及不同病因所致肝损害患者的OBI发生率进行分析。结果以巢氏PCR结果2个或2个以上区段同时阳性判定为OBI,110例入选患者OBI阳性率为23.6%(26/110);不同性别、年龄段、血清学模式患者OBI发生率差异无统计学意义。肝功能异常组OBI发生率明显高于正常组(35.1%vs 11.3%),两者比较差异有统计学意义(P0.01);不明原因肝损害及有明确病因肝损害的OBI发生率分别为31.0%(9/29)和39.3%(11/28),差异无统计学意义。结论在HBs Ag阴性患者中,OBI更易发生在有肝功能损害的患者。当HBs Ag阴性患者肝损害原因不明时,应及时采用高灵敏HBV DNA检测方法以排除HBV隐匿性感染。
[Abstract]:Objective to analyze the clinical features of patients with occult hepatitis B virus infection (OBI). Methods from March 2012 to January 2014, 110 patients with HBs Ag-negative HBs DNA were enrolled in this study. The serum HBV DNA was extracted by high purity virus nucleic acid detection kit, and the region of HBV DNA was amplified by nested PCR. The incidence of OBI in patients with different sex, age and serological model [anti-HBc () and anti-HBc (卤)] and patients with liver damage caused by different etiology were analyzed. Results the positive rate of OBI in 110 patients with OBI was 23.626 / 110 according to the results of two or more sections of PCR. There was no significant difference in the incidence of OBI among different sex, age group and serological model patients. The incidence of OBI in the group of abnormal liver function was significantly higher than that in the normal group (35. 1% vs 11. 3%), the difference between the two groups was statistically significant (P 0. 01), and the incidence of liver damage of unknown cause and liver damage with definite etiology was 31. 0% 9 / 29) and 39. 3% / 28%, respectively. There was no significant difference between the two groups. Conclusion OBI is more likely to occur in patients with liver dysfunction in HBs Ag negative patients. When the cause of liver damage in HBs Ag negative patients is unknown, high sensitive HBV DNA detection method should be used in time to exclude HBV occult infection.
【作者单位】：重庆医科大学附属第一医院感染科;德阳市人民医院感染科;大足县人民医院感染科;重庆市第九人民医院感染科;嘉兴市第一人民医院感染科;
【基金】：国家自然科学基金(3097258)~~
【分类号】：R512.62

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