中文摘要：

目的观察未经抗病毒治疗（ART）的人类免疫缺陷病毒（HIV）感染者和普通人群隐匿性乙型肝炎流行状况，评估HW感染者合并隐匿性乙型肝炎的临床特点。方法通过酶联免疫分析法检测未经ART治疗的HⅣ感染者和普通人群血浆HBsAg、抗-HBs、HBeAg、抗-Be和抗-HBc水平，筛查出HBsAg阴性的HⅣ感染者（感染组）249例，健康体检者HBsAg阴性者121例（健康组），再采用罗氏COBASAmpliPrep／COBASTaqManHBVTest，version2．0试剂盒检测外周血HBVDNA水平。统计分析用STATA10软件处理本实验各组数据。用Fisher。S精确概率检验、秩和检验。结果感染组HBVDNA阳性者24例，隐匿性乙型肝炎占9．7％，健康组HBVDNA阳性者4例，隐匿性乙型肝炎占3．3％，两组比较，P=0．035，差异有统计学意义。感染组24例HBVDNA阳性者，HBVDNA载量最低者血中能测到，但在检测值水平以下，（即〈20IU／Inl），最高者3．22×10’IU／t02。大于100IU／ml占37．5％（9／24），20～99IU／rnl占16．7％（4／24），〈20IU／ml，但可测出HBVDNA占45．8％（11／24）。HIV感染者抗-HBc（＋）／抗-HBs（＋）组、抗-HBc（＋）／抗-HBs（-）组、抗-HBc（-）／抗-HBs（＋）组、抗-HBc（-）／抗-HBs（-）组DNA阳性率分别为7．3％（8／110），20．8％（11／53），14．3％（3／21），3．1％（2／64），抗-HBc（＋）／抗-HBs（-）组分别与抗-HBc（＋）／抗-HBs（＋）组、抗-HBc（-）／抗-HBs（-）组两组比较，尸值分别为0．018和0．003，差异有统计学意义。四组间HBVDNA病毒载量比较，尸=0．805，差异无统计学意义。感染组HBVDNA（＋）组与HBVDNA（-）组比较，CD4计数∽=1．902，P=0．0586）和ALT水平汜=1．401，P=0．1611）差异无统计学意义。结论在未经ART治疗HⅣ感染者中，隐匿性乙型肝炎高于普通人群，HⅣ感染者抗-HBc（＋）／抗-HBs（-）组隐匿性乙型肝炎最高。

英文摘要：

Objective To investigate and analyze the differential prevalence, as well as the risk factors and clinical features, of occult hepatitis B virus （HBV） infection in the human immunodeficiency virus （HIV）-infected population without antiretroviral therapy （ART） as compared to the general （non-HIV- infected） population. Methods Two-hundred-and-forty-eight individuals with confirmed HIV infection but ART na＇fve （males： 220, females： 28; 15-82 years old） were enrolled in the study, along with 121 healthy individuals （confirmed HIV antibody-negative; males： 53, females： 68; 20-88 years old）. HBV markers （hepatitis B surface antigen （HBsAg）; hepatitis B e antigen （HBeAg）; anti-HBs, anti-HBe and anti-hepatitis B core （HBc） antibodies） were detected by microparticle enzyme-linked immunosorbent assay （AxSYM immunology analyzer manufactured by Abbott Laboratories）; all cases and controls were confirmed negative for hepatitis B surface antigen （HBsAg）. Then, the HBV DNA level in serum was detected using nucleic acid amplification assay （COBAS AmpliPrep/COBAS TaqMan HBV test, version 2.0 manufactured by Roche）. CD4＋ T lymphocytes were measured by flow cytometry, and alanine aminotransferase （ALT, marker of liver function） was measured by enzymatic assay. Results Twenty-four of the HIV cases （9.7%） and four of the healthy controls （3.3%） tested positive for HBV DNA; the amount of individuals with HBV DNA-positivity was significantly higher in the HIV-infected group （P = 0.035）. Among the 24 cases of HBV DNA（＋） HIV-infected individuals, the lowest HBV DNA load was 〈 20 IU/ml and the highest was 3.22 ~ 105 IU/ml; nine of the individuals （37.5%） had HBV DNA load 〉 100 IU/ml, four （16.7%） had 20-99 IU/ ml, and 11 （45.8%） had 〈 20 IU/ml. Among the total HIV-infected cases with HBV DNA-positivity, 7.3% （8/110） were anti-HBc（＋）/anti-HBs（＋）, 20.8% （11/53） were anti-HBc（＋）/anti-HBs（-）, 14.3 % （3/21）