摘要
目的探讨有乙型肝炎病毒(hepatitis virus B,HBV)感染史的自身免疫性肝炎(autoimmune hepartitis,AIH)患者的病毒学特征。方法回顾性分析2012年8月—2022年8月北京佑安医院诊治的180例AIH患者的临床资料,比较有/无既往HBV感染AIH患者的实验室相关指标;利用巢式PCR和Real-time PCR进行HBV DNA检测,以确定AIH患者是否存在隐匿性HBV感染(occult HBV infection,OBI),并进一步明确其病毒学特征。结果AIH患者中有HBV感染史者占38.89%(70/180)。既往HBV感染组患者的抗核抗体(1:320~1:1000)的比例显著高于无HBV感染史组(χ^(2)=4.210,P=0.040)。病毒学检测结果发现,27.27%(12/44)既往HBV感染的AIH患者中存在OBI;OBI患者HBV基因型为B、C型及B/C混合型;在HBV S区阅读框,C基因型的氨基酸突变位点数高于B基因型,B/C混合感染的患者具有更多的氨基酸突变位点;在主要亲水区发现多个免疫逃逸相关突变位点(如sT125A,sI126T等),截短突变位点(sC137^(*))和缺失突变位点(AAs 113~116)。结论有HBV感染史的AIH患者中存在OBI的可能。HBV S区部分氨基酸位点的突变,可能与OBI产生有关。
Objective To investigate the virological characteristics of autoimmune hepatitis patients with previous hepatitis virus B(HBV)infection.Methods A total of 180 patients with autoimmune hepatitis(AIH)diagnosed in Beijing YouAn Hospital from August 2012 to August 2022 were retrospectively analyzed.The clinical characteristics and laboratory indicators were compared.The diagnosis of Occult HBV infection(OBI)was confirmed by nested PCR and Real-time PCR,and the virological characteristics were further studied.Results The prevalence of previous HBV infection in AIH patients was 38.89%(70/180).The ratio of antinuclear antibody(ANA)(1:320~1:1000)in AIH patients with previous HBV infection was significantly higher than that in patients without previous HBV infection(χ^(2)=4.210,P=0.040).The results of virological examination showed that OBI was present in 27.27%(12/44)of AIH patients with previous HBV infection.The HBV genotypes of OBI patients were B,C and B/C mixed.In the reading frame of HBV S region,the amino acid mutation sites of C genotype were more than those of B genotype,and the number of amino acid mutation sites of B/C mixed infection was more than that of single genotype infection.Multiple immune escape associated mutation sites(sT125A,sI126T,etc.),truncated mutation sites(sC137^(*)),and deleted mutation sites(AAs 113~116)were found in major hydrophilic regions(MHR).Conclusions OBI may exist in AIH patients with previous HBV infection.The mutation of some amino acid sites in S region of HBV may be related to the cause of OBI.
作者
陈欣欣
张海萍
黄春洋
闫惠平
CHEN Xinxin;ZHANG Haiping;HUANG Chunyang;YAN Huiping(Center of Clinical Laboratory,Beijing Friendship Hospital,Capital Medical University,100050,China;Center of Clinical Laboratory,Beijing YouAn Hospital,Capital Medical University,100069,China;不详)
出处
《传染病信息》
2024年第1期5-10,共6页
Infectious Disease Information
基金
北京市自然科学基金(7111004)
北京市医管局培育项目(PX2019062)。
