Chan Henry Lik-Yuen, Tsang Steven Woon-Choi, Leung Nancy Wai-Yee, Tse Chi-Hang, Hui Yui, Tam John Siu-Lun, Chan Francis Ka-Leung, Sung Joseph Jao-Yiu
Department of Medicine & Therapeutics and Microbiology, the Chinese University of Hong Kong, Shatin.
Am J Gastroenterol. 2002 May;97(5):1211-5. doi: 10.1111/j.1572-0241.2002.05706.x.
Hepatitis B surface antigen (HBsAg) is often used as the serological marker to screen for hepatitis B virus (HBV) infection in the investigation of liver cirrhosis. In Hong Kong, where HBV infection is endemic, some patients may have persistent viral infection after the loss of HBsAg. We aimed to investigate 1) the prevalence of occult HBV infection in cryptogenic liver cirrhosis in Hong Kong and 2) the role of HBV "a" determinant mutations among these patients.
Twenty-eight patients with cryptogenic liver cirrhosis (group I), 49 subjects with no liver disease (group II), and 26 patients with HBV-related cirrhosis (group III) were studied. HBV DNA was determined by the cross-linking assay (sensitivity = 0.5 mEq/ml) and polymerase chain reaction (PCR). Occult HBV infection was defined as HBV DNA detectable by PCR among patients with negative HBsAg.
Eighty-nine percent and 92% of patients in groups I and II, respectively, had positive anti-HBs and/or anti-hepatitis B core. Nine (32%), no (0%), and 14 (54%) patients in groups I, II, and III, respectively, had detectable HBV DNA by PCR (group I vs group II, p < 0.001; group I vs group III, p = 0.36). Four patients in group I had HBV DNA detectable by the cross-linking assay (median = 5.98 mEq/ml, range = 3.1-8.01). "a" determinant mutations were detected in two patients in group I (K122N and G145R, C125A) and one patient in group II (1126N).
Occult HBV infection is common among patients with cryptogenic liver cirrhosis, and it cannot be explained by mutations in the HBV "a" determinant.
在肝硬化调查中，乙肝表面抗原（HBsAg）常被用作筛查乙肝病毒（HBV）感染的血清学标志物。在HBV感染呈地方性流行的香港，一些患者在HBsAg消失后可能仍存在持续性病毒感染。我们旨在调查1）香港隐源性肝硬化患者中隐匿性HBV感染的患病率，以及2）这些患者中HBV “a” 决定簇突变的作用。
对28例隐源性肝硬化患者（I组）、49例无肝病受试者（II组）和26例HBV相关性肝硬化患者（III组）进行研究。采用交联检测法（灵敏度 = 0.5 mEq/ml）和聚合酶链反应（PCR）检测HBV DNA。隐匿性HBV感染定义为HBsAg阴性患者中PCR检测可检出HBV DNA。
I组和II组分别有89% 和92% 的患者抗-HBs和/或抗乙肝核心抗体呈阳性。I组、II组和III组分别有9例（32%）、0例（0%）和14例（54%）患者通过PCR检测可检出HBV DNA（I组与II组比较，p < 0.001；I组与III组比较，p =
0.36）。I组有4例患者通过交联检测法可检出HBV DNA（中位数 = 5.98 mEq/ml，范围 = 3.1 - 8.01）。I组有2例患者（K122N和G145R、C125A）和II组有1例患者（1126N）检测到 “a” 决定簇突变。
隐匿性HBV感染在隐源性肝硬化患者中很常见，且不能用HBV “a” 决定簇突变来解释。
