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目的探讨肝细胞乙肝病毒共价闭合环状脱氧核糖核酸(HBV cccDNA)与血清HBV复制指标的关系和临床意义,为临床判断抗HBV疗程终点提供参考。方法选取郑州大学第一附属医院收治的HBsAg/HBeAg/抗-HBc阳性患者64例、HBsAg/抗-HBe/抗-HBc阳性患者68例和既往HBV感染自然恢复者40例,将血清HBV DNA、HBVM及肝细胞HBV cccDNA检测结果进行对照分析。结果 HBsAg/HBeAg/抗-HBc阳性患者和HBsAg/抗-HBe/抗-HBc阳性患者中HBV DNA阳性者分别为64例(100%)和22例(32.4%),肝细胞HBV cccDNA全部阳性;既往HBV感染自然恢复的40例患者中,HBsAg阴性,抗-HBs阳性的20例中肝细胞HBV cccDNA全部阴性,抗-HBs阴性的20例中有6例肝细胞HBV cccDNA阳性(103拷贝/ml)。同时,对132例HBsAg阳性患者的HBsAg定量结果与其肝细胞HBV cccDNA检测结果分析发现血清HBsAg变化与肝细胞HBV cccDNA正相关。结论抗-HBs阳性HBV感染后恢复期血清,肝组织HBV cccDNA趋于完全清除,抗病毒治疗CHB的终点,应是血清抗-HBs阳性的出现。
Objective To investigate the relationship and clinical significance of hepatocellular hepatitis C virus covalently closed circular deoxyribonucleic acid (HBV cccDNA) and HBV replication markers and provide a reference for judging the end point of anti-HBV therapy. Methods Sixty-four HBsAg / HBeAg / anti-HBc positive patients, 68 HBsAg / anti-HBe / anti-HBc positive patients and 40 former HBV infection recovered patients were selected from the First Affiliated Hospital of Zhengzhou University. Serum HBV DNA, HBVM and hepatocyte HBV cccDNA test results were compared. Results The positive HBV DNA in HBsAg / HBeAg / anti-HBc positive patients and HBsAg / anti-HBe / anti-HBc positive patients were 64 (100%) and 22 (32.4% Of the 40 patients who had recovered from previous HBV infection, all of the 20 patients with HBsAg-negative and anti-HBs-positive HBV cccDNA were all negative, and 6 of the 20 patients with anti-HBs-negative HBV cccDNA were positive (103 copies / ml ). Meanwhile, the quantitative analysis of HBsAg in 132 HBsAg-positive patients and the results of HBV cccDNA detection in hepatocytes showed that the serum HBsAg level was positively correlated with the level of HBV cccDNA in hepatocytes. Conclusions HBV cccDNA in serum and liver tissue of convalescent patients after anti-HBs positive HBV infection tends to be completely eliminated. Anti-HBV treatment should be the positive of serum anti-HBs.