Fan Chun-Lei, Wei Lai, Jiang Dong, Chen Hong-Song, Gao Yan, Li Ruo-Bing, Wang Yu
Institute of Hepatology, People's Hospital, Peking University, Beijing 100044, China.
World J Gastroenterol. 2003 Sep;9(9):2012-6. doi: 10.3748/wjg.v9.i9.2012.
To investigate the clinical and virological course of coinfection by hepatitis B virus (HBV) and hepatitis C virus (HCV) in China.
We enrolled 40 patients with chronic HBV and HCV coinfection (Group BC), 16 patients with chronic HBV infection (Group B) and 31 patients with chronic HCV infection (Group C). They infected HBV and/or HCV during 1982 to 1989. Sera of all the 87 patients were collected in 1994 and 2002 respectively. We detected biochemical and virologic markers and serum HBV DNA and HCV RNA levels of all the patients. B-type ultrasound detection was performed in some patients.
In Group BC, 67.5 % of the patients cleared HBsAg, and 92.5 % of the patients cleared HBeAg. The clearance rate of HBV DNA was 87.5 %. There was no significant difference of HBV clearance between Group BC and Group B. In Group BC, 85.7 % of males and 47.4 % of females cleared HBV, and males were easier to clear HBV (chi(2)=6.686, P=0.010). Such a tendency was also found in Group B. The clearance rate of HCV RNA in Group BC was 87.5 %, significantly higher than that in Group C (chi(2)=22.963, P<0.001). Less than 40 % of the patients in all groups had elevated liver enzyme values. The highest value of alanine aminotransferase (ALT) was 218 u/L (normal range for ALT is 0-40 u/L). In most patients the ultrasonogram presentations changed mildly.
The clinical manifestations of patients with HBV/HCV coinfection are mild and occult. High clearance rate of HBV and easy to clear HBV in male patients are the characteristics of HBV infection in adults in China. HBV can inhibit HCV replication, but no evidence has been found in our data that HCV suppresses HBV replication.
调查中国乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）合并感染的临床及病毒学病程。
我们纳入了40例慢性HBV和HCV合并感染患者（BC组）、16例慢性HBV感染患者（B组）和31例慢性HCV感染患者（C组）。他们于1982年至1989年期间感染了HBV和/或HCV。分别于1994年和2002年收集了所有87例患者的血清。我们检测了所有患者的生化和病毒学标志物以及血清HBV DNA和HCV RNA水平。对部分患者进行了B型超声检查。
在BC组中，67.5%的患者清除了HBsAg，92.5%的患者清除了HBeAg。HBV DNA清除率为87.5%。BC组和B组之间HBV清除率无显著差异。在BC组中，85.7%的男性和47.4%的女性清除了HBV，男性更容易清除HBV（χ² = 6.686，P = 0.010）。B组也发现了这种趋势。BC组中HCV RNA清除率为87.5%，显著高于C组（χ² = 22.963，P < 0.001）。所有组中不到40%的患者肝酶值升高。丙氨酸氨基转移酶（ALT）的最高值为218 U/L（ALT正常范围为0 - 40 U/L）。大多数患者的超声检查表现变化轻微。
HBV/HCV合并感染患者的临床表现轻微且隐匿。成人HBV感染的特点是HBV清除率高且男性患者易于清除HBV。HBV可抑制HCV复制，但我们的数据中未发现HCV抑制HBV复制的证据。
