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采用ELISA法检测了108例乙型肝炎病毒(HBV)感染者血清中的五种肝炎病毒──甲型(HAV)、乙型(HBV)、丙型(HCV)、丁型(HDV)和成型(HEV)肝炎病毒的标志物,并采用PCR技术检测了患者血清HBVDNA、HCVRNA及HDVRNA。结果五种肝炎病毒重叠感染者35例(32.4%),单纯HBV感染者73例(67.6%)。HBV、HAVM重感染率为4.6%,HBV、HCV二重感染率为9.2%,HBV、HDVM重感染率为14.8%,HBV、HEV二重感染率为1.9%,HBV、HCV和HDV三重感染率为1.9%。HBV、HDV二重感染者发生肝硬化(LC)的频率明显高于单纯HBV感染者(P<0.01)。在慢性乙肝和LC患者中,HBV、HCV二重感染,HBV、HBV二重感染和单纯HBV感染者血清HBeAg、HBVDNA阳性率之间无显著差别。上述结果提示五型肝炎病毒重叠感染情况比较严重;HDV感染可导致肝炎慢性化、肝组织损伤加重和肝硬化的发生。HCV和HDV感染对HBV复制无明显影响。
The five hepatitis viruses in the serum of 108 patients with hepatitis B virus (HBV) were tested by ELISA, including HAV, HBV, HDV and HDV (HEV) markers of hepatitis virus, and serum HBVDNA, HCVRNA and HDVRNA were detected by PCR. Results 35 patients (32.4%) were infected with five hepatitis viruses and 73 patients (67.6%) were infected with HBV alone. HBV, HAVM heavy infection rate was 4.6%, HBV, HCV double infection rate was 9.2%, HBV, HDVM heavy infection rate was 14.8%, HBV, HEV double infection rate was 1.9% The triple infection rates of HBV, HCV and HDV were 1.9%. The incidence of cirrhosis (LC) in HBV and HDV patients was significantly higher than that in HBV patients (P <0.01). In patients with chronic hepatitis B and LC, there was no significant difference in the positive rates of serum HBeAg and HBVDNA among patients with dual infection of HBV and HCV, double infection of HBV and HBV and pure HBV infection. The above results suggest that the hepatitis C virus is more likely to overlap with each other. HDV infection can lead to chronic hepatitis, increased hepatic injury and cirrhosis. HCV and HDV infection had no significant effect on HBV replication.