Shang Qing-hua, Yu Jian-guo, Xu Chuan-zhen, Xiao De-ming, Yin Yan-ming, Chen Chong-xing, Zhang Guang-shu
Institute of Liver Disease, Jinan Military Region, The No 88 Hospital of the People's Liberation Army, Taian, China.
Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2005 Mar;19(1):32-4.
To observe the effect of hepatitis C virus (HCV) superinfection on the short-term and long-term hepatic pathological changes in patients with chronic hepatitis B (CHB).
HCV-RNA of twice corresponding period serum samples was detected via reverse transcription polymerase chain reaction assay from 230 patients with CHB for whom liver biopsy was performed at an interval of 0.5-15 years, respectively. The hepatic pathological changes of the patients with CHB who were serum HCV-RNA positive at the beginning of observation and persistently positive between the starting and ending of observation were respectively compared with those of serum HCV-RNA negative and persistently negative patients.
41 patients (17.83%) were positive for serum HCV-RNA at the beginning of observation. There were significant differences in the severity of hepatic inflammatory activity grade and fibrosis stage between serum HCV-RNA positive and negative patients with CHB (P < 0.05). Twenty-nine patients were persistently positive for serum HCV-RNA in the beginning and end of observation. Compared with persistently negative patients who were 116 patients selected from the above-mentioned 230 patients and they were comparable with HCV-RNA persistently positive patients in mean follow-up time, age and sex, the long-term progression of hepatic inflammatory activity grade and fibrosis stage in persistently positive patients were more speedy (P < 0.01).
HCV superinfection worsens the hepatic pathological changes of patients with CHB and speeds up its progression.
观察丙型肝炎病毒(HCV)重叠感染对慢性乙型肝炎(CHB)患者短期和长期肝脏病理变化的影响。
采用逆转录聚合酶链反应法检测230例CHB患者相应时期两次血清样本的HCV-RNA,这些患者分别在0.5至15年的间隔期内接受了肝活检。将观察开始时血清HCV-RNA阳性且在观察开始至结束期间持续阳性的CHB患者的肝脏病理变化,分别与血清HCV-RNA阴性且持续阴性的患者进行比较。
41例患者(17.83%)在观察开始时血清HCV-RNA阳性。CHB患者中血清HCV-RNA阳性和阴性者在肝脏炎症活动度分级和纤维化分期的严重程度上存在显著差异(P<0.05)。29例患者在观察开始和结束时血清HCV-RNA持续阳性。从上述230例患者中选取116例血清HCV-RNA持续阴性的患者,这些患者在平均随访时间、年龄和性别方面与HCV-RNA持续阳性的患者具有可比性。与持续阴性的患者相比,持续阳性患者肝脏炎症活动度分级和纤维化分期的长期进展更快(P<0.01)。
HCV重叠感染会加重CHB患者的肝脏病理变化并加速其进展。