摘要
目的调研自身免疫性肝炎(AIH)患者隐匿性乙型肝炎(OBI)的患病率并分析其病毒学特征。方法连续选取2015年1月—2022年8月期间海安市人民医院收治的AIH患者69例,其中男性7例、女性62例,年龄50(30,73)岁。AIH诊断符合要求。检测血生化指标、血清学标志物、自身抗体,提取HBV DNA,半巢式PCR方法扩增HBV DNA阳性样品中S区(122个核苷酸结合位点:84至205),获得PCR产物序列,经电泳鉴定、回收纯化后进行测序,序列输入HBVseq数据库,得到核苷酸替换位点以及基因分型结果。结果OBI阳性、阴性病例分别为14例、55例,AIH患者OBI阳性率为20.3%。OBI阳性、阴性AIH患者抗-HBc、抗-HBs及抗-HBe(+)例数分别为5例(35.7%)、7例(12.7%),差异具有统计学意义(P<0.05);而两组患者肝功能、自身抗体及肝硬化等差异不具有统计学意义(P>0.05)。为评估AIH患者OBI隐匿状态与HBV基因突变的关系,我们分析了S区核苷酸结合位点替换情况。HBV基因分型结果显示,14例OBI阳性AIH患者中B型、C型分别为6例(42.8%)、8例(57.2%)。基因B型、C型OBI阳性AIH患者S区核苷酸替换位点分别为1(1/122,0.8%)、12(12/122,9.8%),差异具有统计学意义(P<0.05);两组总的核苷酸结合位点替换频率为0.1%(1/122*6)、1.2%(12/122*8),差异具有统计学意义(P<0.05)。结论AIH患者中OBI阳性率为20.3%,AIH患者OBI的出现与S区核苷酸结合位点替换或突变有关,具有一定的预测性临床意义。
Objective To investigate the prevalence of occult hepatitis B virus(HBV)infection(OBI)in autoimmune hepatitis(AIH)patients and to elucidate its virological characteristics.Methods From January 2015 to August 2022,A total of 69 patients with AIH admitted to hospital were selected,including 7 males and 62 females,aged 50(30,73)years.The diagnostic criteria for AIH were rigorously adhered to,meeting all established requirements.Comprehensive assays were performed to evaluate blood biochemical indices,serological markers,and autoantibodies,HBV DNA was isolated,and the S region(nucleotide sites:84-205)was amplified using semi-nested PCR techniques to generate the target sequence.Following electrophoretic verification,the PCR products were recovered,purified,and sequenced.The resultant sequences were uploaded to the HBVseq database for nucleotide substitution analysis and genotyping.Results In our cohort of 69 AIH patients,the prevalence of OBI was 20.3%,with 14 positive and 55 negative cases.A statistically significant higher prevalence of HBcAb,HBsAb and HBeAb was noted among the OBI-positive cases(35.7%)compared to OBI-negative cases(12.7%)(P<0.05).However,no significant differences were observed in liver function,autoantibodies,or cirrhosis between the two groups(P>0.05).To explore the relationship between OBI status and HBV genotypic variations,we analyzed nucleotide substitution sites within the S region.Among the OBI-postive AIH cases,genotype B was present in 42.8%(6 cases),ad genotype C 57.2%(8cases Notably,the nucleotide substitution frequencies within the S region differed significantly between genotypes B(0.8%)and C(9.8%)(P<0.05).Calculated overall nucleotide substitution frequencies for the two groups were 0.1%and 1.2%,respectively,which was also statistically significant(P<0.05).Conclusion In our studu involving 68 AIH patients,a 20.3%prevalence of OBI is identified.Notably,the incidence of OBI in AIH patients-correlated significantly with nucleotide substitution or mutation within the S region of the HBV
作者
王美娟
谢群
王华雨
WANG Mei-juan;XIE Qun;WANG Hua-yu(Department of Infection,Hai′an People′s Hospital,Jiangsu 226600,China)
出处
《肝脏》
2023年第10期1215-1218,共4页
Chinese Hepatology
基金
南通市科技计划项目(MSZ19124)。
