摘要
目的调查四川地区自然人群中隐匿性乙型肝炎病毒(OBI)感染状况及病毒学特征。方法筛查四川地区自然人群OBI感染率,检测乙型肝炎病毒(HBV)标志物[乙肝e抗原(HBeAg)、乙型肝炎表面抗原(HBsAg)、乙肝核心抗原(HBcAg)],行HBsAg,抗-HBs定量和抗-HBe及抗-HBc的定性检测,实时定量荧光聚合酶链反应(RT-PCR)检测HBsAg(-)/HBcAb(+)患者血清样品,检测血液中谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBil)水平。分析OBI患者病毒学特征和基因型。结果116668份血液标本,HBsAg(阴性)但HBV DNA(阳性)检出率为0.098%,0.085%为OBI。99例OBI感染人群血清学特征中占比最高为抗-HBc阳性(40.40%),其次为抗-HBc阳性/抗-HBs阳性(26.26%),抗-HBc阳性/抗-HBe阳性次之(24.24%),抗-HBc阳性/抗-HBs阳性/抗-HBe阳性(9.09%)最低。抗-HBc阳性/抗-HBe阳性OBI患者病毒载量最高,其次为抗-HBc阳性/抗-HBs阳性者、抗-HBc阳性者、抗-HBc阳性/抗-HBs阳性/抗-HBe阳性者,四者间比较差异有统计学意义(P<0.05)。OBI患者中共19例标本中的毒株系列在表面抗原“a”区域出现异常变异(占比19.19%),“a”决定簇突变中决定性基因有Q129R、T126A和D144E。结论四川地区自然人群OBI感染风险高,多表现抗-HBc阳性,OBI病毒基因以B型为主,Q129R、T126A和D144E的突变与OBI感染的发生相关。
OBJECTIVE To investigate the prevalence and virological characteristics of occult hepatitis B virus infection(OBI)among natural population of Sichuan.METHODS The prevalence rate of OBI was screened among the natural population in Sichuan,the hepatitis B virus(HBV)markers[hepatitis B e antigen(HBeAg),hepatitis B surface antigen(HBsAg),hepatitis B core antigen(HBcAg)]were detected,the quantitative test was performed for HBsAg and anti-HBs,the qualitative test was carried out for anti-HBe and anti-HBc,the serum specimens of the HBsAg(-)/HBcAb(+)patients were detected by real time polymerase chain reaction(RT-PCR),the levels of blood aspartate aminotransferase(AST),alanine aminotransferase(ALT)and total bilirubin(TBil)were detected,and the virological characteristics and genotypes of the OBI patients were observed.RESULTS The detection rate of HBsAg(negative)but HBV DNA(positive)was 0.098%among 116668 blood specimens,0.085%were OBI.Among 99 cases of OBI,40.40%were anti-HBc-positive,26.26%were anti-HBc-positive/anti-HBs-positive,24.24%were anti-HBc-positive/anti-HBe-positive,and 9.09%were anti-HBc-positive/anti-HBs-positive/anti-HBe-positive.The viral load of the anti-HBc-positive/anti-HBe-positive OBI patients was the highest,followed by the anti-HBc-positive/anti-HBs-positive patients,anti-HBc-positive patients,anti-HBc-positive/anti-HBs-positive/anti-HBe-positive patients,and there was significant difference among the four groups(P<0.05).Among the OBI patients,19(19.19%)showed abnormal mutations in the surface antigen a region,and the determinant genes in the’a’determinant mutations were Q129 R,T126 A and D144 E.CONCLUSION The natural population of Sichuan is at high risk of OBI and characterized by anti-HBc-positive.Type B is the main OBI virus genotype.The mutations of Q129 R,T126 A and D144 E are closely related to the occurrence of OBI.
作者
左晓娇
姚晓琴
杨华
蒋丽
关华
ZUO Xiao-jiao;YAO Xiao-qin;YANG Hua;JIANG Li;GUAN Hua(Health Management Center of Sichuan Provincial People's Hospital,University of Electronic Science&Technology of China,Chengdu,Sichuan 610072,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第13期1921-1925,共5页
Chinese Journal of Nosocomiology
基金
四川省科研基金资助项目(JH021014)。
