Ke Wei-min, Lin Guo-li, Ye Yi-long, Lai Jing, Li Jian-guo
Department of Infectious Diseases, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.
Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2005 Mar;19(1):52-4.
To clarify the relationship between fatal severe form hepatitis occurred during chronic hepatitis B and superinfections of hepatitis A, C, D or E virus as well as hepatitis B e system status and to adopt corresponding measures to reduce the mortality of chronic hepatitis B.
This study detected the superinfections with hepatitis A, C, D or E virus and hepatitis B e system status in 219 patients with fatal severe form hepatitis occurred during chronic hepatitis B by enzyme linked immunosorbent assay.
The superinfections with hepatitis A, C, D or E virus were found in 1.4% (3/219), 9.6% (21/219), 1.8% (4/219) and 30.1% (66/219) of the patients, respectively, altogether 42.9% (94/219); hepatitis E was prominent and steady in superinfection rate in recent ten years. The causes of 57.1% (125/219) patients were not clear. The positive rate of HBeAg and anti-HBe were 17.0% (16/94) and 54.2% (51/94) in the group of superinfections with hepatitis A, C, D or E virus; and were 27.2% (34/125) and 47.2% (59/125) in the group with unknown causes, respectively.
These results suggested that the patients with superinfections reached 42.9% (94/219), and the superinfections may be a part of causes of fatal severe form hepatitis, and the mortality of chronic hepatitis B may be decreased by strict food sanitation and use of safe blood products. There were no significant relation between hepatitis B e antigen seroconversion and the fatal severe form hepatitis occurred during chronic hepatitis B.
阐明慢性乙型肝炎病程中发生的致死性重型肝炎与甲型、丙型、丁型或戊型肝炎病毒重叠感染以及乙肝e系统状态之间的关系，并采取相应措施降低慢性乙型肝炎的死亡率。
本研究采用酶联免疫吸附试验检测219例慢性乙型肝炎病程中发生的致死性重型肝炎患者的甲型、丙型、丁型或戊型肝炎病毒重叠感染情况及乙肝e系统状态。
患者中甲型、丙型、丁型、戊型肝炎病毒重叠感染率分别为1.4%（3/219）、9.6%（21/219）、1.8%（4/219）和30.1%（66/219），共42.9%（94/219）；近十年戊型肝炎在重叠感染率方面突出且稳定。57.1%（125/219）患者的病因不明。甲型、丙型、丁型或戊型肝炎病毒重叠感染组HBeAg和抗-HBe阳性率分别为17.0%（16/94）和54.2%（51/94）；病因不明组分别为27.2%（34/125）和47.2%（59/125）。
这些结果提示重叠感染患者达42.9%（94/219），重叠感染可能是致死性重型肝炎的部分病因，严格食品卫生及使用安全血制品可降低慢性乙型肝炎的死亡率。乙肝e抗原血清学转换与慢性乙型肝炎病程中发生的致死性重型肝炎之间无显著关系。
