目的分析我国西南地区慢性乙型肝炎(Chronic hepatitis B,CHB)病毒感染者自然病程中HBV基因分型和定量血清学生物标记物的特征。方法收集我国西南地区140例CHB患者临床资料和全血标本,根据HBV感染自然病程(免疫耐受期、免疫清除期、低复制期和再活动期)分为4组,采用巢式PCR法进行HBV分子基因分型,化学发光微粒子免疫分析法定量检测HBV血清学标记物。结果 CHB患者的HBV基因型以B2和C2亚型为主,且B型患者病情更具进展性;血清HBsAg水平以免疫耐受期组最高,低复制期组最低(P〈0.01);相关性分析显示,HBsAg水平与HBV-DNA、HBeAg、患者年龄、ALT及AST水平显著相关。结论 HBV基因分型和定量血清学标记物分析可能有助于预测HBV相关疾病的远期进展。
Objective To analyze the characteristics of hepatitis B virus(HBV) genotype and quantitative serological markers in natural course of patients with chronic hepatitis B(CHB) in Southwestern China.Methods The clinical data and blood specimens of 140 patients with CHB were collected,and divided into four groups according to the natural course of HBV infection(immune resistance,immune clearance,low replication and reactivation phases) for HBV genotyping by nested PCR,then determined quantitatively for serological markers of HBV by chemiluminescent microparticle immunoassay.Results B2 and C2 were prominent subgenotypes in the patients.However,the disease of patients of genotype B was more progressive.The serum HBsAg levels of patients at immune resistance phase were the highest,while those at low replication phase were the lowest(P 〈 0.01).The HBsAg level was significantly related with the HBV-DNA,HBeAg,ALT and AST levels as well as age of patients.Conclusion HBV genotyping and quantitative analysis of serological markers may be helpful to the prediction of long-term outcomes of HBV-related diseases.