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目的了解HBsAg阴性、抗-HBe和/或抗-HBc阳性人群中隐匿型乙型肝炎病毒的感染情况。方法应用荧光定量聚合酶链反应(PCR)方法检测187例HBsAg阴性、抗-HBe和/或抗-HBc阳性(ELISA方法)人群血清中HBV-DNA含量,并采用Abbot(雅培试剂)检测HBsAg。结果187例HBsAg阴性、抗-HBe和/或抗-HBc阳性(ELISA方法)的人群血清中HBV-DNA阳性率为6.42%(12/187),HBsAg阳性(Abbot方法)率为24.6%(46/187)。抗-HBs和抗-HBe阳性(A组)5例,抗-HBc阳性(B组)30例,抗-HBs和抗-HBc阳性(C组)4例,抗-HBe和抗-HBc阳性(D组)116例,抗-HBs,抗-HBe和抗-HBc同时阳性(E组)32例。以抗-HBe和抗-HBc同时阳性的模式(D组)为主,占62.0%(116/187),既往有慢乙肝病史率最高,达36.2%。B、D、E组均有一定比例HBsAg(Abbot方法)阳性率,其中以D组最高,达32.76%;其次为B组,HBsAg阳性率20%;E组HBsAg阳性率6.25%,差异有统计学意义(χ2=13.251,P<0.01)。抗-HBs阳性(包括A、C、E组)与抗-HBs阴性(包括B、D组)人群的HBsAg阳性率分别为4.88%(2/41)与30.14%(44/146),差异有显著性统计学意义(χ2=15.936,P<0.001)。结论HBsAg阴性、抗-HBe和/或抗-HBc阳性人群中存在隐匿型HBV感染。应进一步进行更敏感的方法如化学发光法检测HBsAg或PCR定量检测HBV-DNA,以免误诊与漏诊。
Objective To understand the prevalence of occult hepatitis B virus in HBsAg-negative, anti-HBe and / or anti-HBc-positive individuals. Methods Serum HBV-DNA levels in 187 HBsAg-negative, anti-HBe and / or anti-HBc positive (ELISA) patients were measured by fluorescence quantitative polymerase chain reaction (PCR) and HBsAg was detected by Abbot. Results Seroprevalence of HBV-DNA in 187 HBsAg-negative, anti-HBe and / or anti-HBc positive (ELISA) patients was 6.42% (12/187) and HBsAg positive (Abbot method) was 24.6% / 187). Anti-HBs and anti-HBe positive (group A) 5 cases anti-HBc positive (group B) 30 cases anti-HBs and anti-HBc positive group C 4 cases anti-HBe and anti-HBc positive Group D) 116 cases, anti-HBs, anti-HBe and anti-HBc simultaneously positive (E group) 32 cases. Anti-HBe and anti-HBc simultaneously positive model (D group), accounting for 62.0% (116/187), the history of chronic hepatitis B had the highest rate of 36.2%. The positive rates of HBsAg (Abbot method) in group B, D and E were the highest, reaching 32.76% in group D, the second was in group B, the positive rate of HBsAg was 20%, and the positive rate of HBsAg in group E was 6.25% Significance (χ2 = 13.251, P <0.01). The positive rates of HBsAg in anti-HBs (including A, C and E groups) and anti-HBs (including B and D groups) were 4.88% (2/41) and 30.14% (44/146) Significant statistical significance (χ2 = 15.936, P <0.001). Conclusions There are occult HBV infections in HBsAg-negative, anti-HBe and / or anti-HBc-positive cohorts. Further more sensitive methods such as chemiluminescence detection of HBsAg or PCR quantitative detection of HBV-DNA, so as to avoid misdiagnosis and missed diagnosis.