Kazemi-Shirazi L, Petermann D, Müller C
Universitätsklinik für Innere Medizin IV, Klinische Abteilung für Gastroenterologie und Hepatologie, University of Vienna, Austria.
J Hepatol. 2000 Nov;33(5):785-90. doi: 10.1016/s0168-8278(00)80311-6.
BACKGROUND/AIMS: Hepatitis B virus (HBV) DNA has been detected in HBsAg-negative patients with hepatitis C. We determined the rate and explored the clinical significance of HBsAg negative HBV coinfections in Austrian patients with chronic hepatitis C.
Sera (n=82, group I) or liver tissue (n=16, group II) from 98 HBsAg negative Austrian patients with chronic hepatitis C were examined for HBV DNA by nested polymerase chain reaction (PCR). For control purposes, sera from 15 patients with chronic HBV infection (8 HBsAg positive, 7 HBsAg negative, all HBV PCR positive) were examined.
HBV DNA was detected in 22% of sera and 19% of liver tissue specimens of patients with chronic hepatitis C. No significant difference in mean aminotransferase values, markers of HBV infection, inflammatory disease activity, or degree of hepatic fibrosis was observed in patients with or without HBV DNA. Anti-HBc alone as a marker of past HBV infection was more frequent in chronic hepatitis C patients compared to control individuals. Negative HCV PCR was more common (p=0.009) among patients with positive HBV PCR in serum. When examining repeat sera for HBV DNA, positive results were obtained in previously negative, but also negative results in previously positive patients.
Coinfection with HBV can be demonstrated by PCR in a considerable number of HBsAg negative Austrian patients with chronic hepatitis C. HBV infection seems to suppress HCV replication even in HBsAg negative patients with dual infection. HBV coinfection in HCV infected patients cannot be excluded by negative HBsAg status alone. Repeat PCR examinations are needed to exclude dual infections.
背景/目的：在丙型肝炎表面抗原（HBsAg）阴性的患者中已检测到乙肝病毒（HBV）DNA。我们确定了奥地利慢性丙型肝炎患者中HBsAg阴性HBV合并感染的发生率，并探讨其临床意义。
采用巢式聚合酶链反应（PCR）检测98例奥地利HBsAg阴性慢性丙型肝炎患者的血清（n = 82，第一组）或肝组织（n = 16，第二组）中的HBV DNA。作为对照，检测了15例慢性HBV感染患者（8例HBsAg阳性，7例HBsAg阴性，所有HBV PCR均为阳性）的血清。
在慢性丙型肝炎患者的22%血清和19%肝组织标本中检测到HBV DNA。有无HBV DNA的患者在平均转氨酶值、HBV感染标志物、炎症疾病活动度或肝纤维化程度方面均未观察到显著差异。与对照组相比，仅抗-HBc作为既往HBV感染标志物在慢性丙型肝炎患者中更为常见。血清中HBV PCR阳性的患者中HCV PCR阴性更为常见（p = 0.009）。在检测HBV DNA的重复血清时，先前阴性的患者获得了阳性结果，但先前阳性的患者也获得了阴性结果。
通过PCR可在相当数量的奥地利HBsAg阴性慢性丙型肝炎患者中证实HBV合并感染。即使在HBsAg阴性的双重感染患者中，HBV感染似乎也会抑制HCV复制。仅HBsAg阴性状态不能排除HCV感染患者中的HBV合并感染。需要重复进行PCR检测以排除双重感染。
