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希腊慢性丙型肝炎病毒感染注射吸毒者的乙肝病毒感染血清学特征及肝脏组织病理学

Serological profile of HBV infection and liver histopathology among injecting drug users with chronic HCV infection in Greece.

作者信息

Elefsiniotis Ioannis S, Hero Brokalaki, Mariolis Anargiros, Pantazis Konstantinos D, Fotos Nikolaos V, Ketikoglou Ioannis, Saroglou George

机构信息

National and Kapodistrian University of Athens, School of Nursing, Athens, Greece.

出版信息

Eur J Intern Med. 2005 Nov;16(7):496-500. doi: 10.1016/j.ejim.2005.05.004.

Abstract

BACKGROUND

The aim of this study was to evaluate the serological status of HBV infection and liver histology in chronic HCV-infected injecting drug users (IDUs) and to correlate them with the possible time of infection and the principal HCV genotype.

METHODS

Some 130 prior IDUs with chronic HCV infection were consecutively evaluated for the serological status of HBV infection. Fifty-eight (44.62%) reported intravenous drug use beginning before 1992 (group A) and 72 (55.38%) after 1992 (group B). HCV genotyping was available in 86 patients (PCR). Liver biopsy was performed in 48 patients (Ishak scoring system). There was no available data about alcohol consumption in the study population. Statistical analysis was based on the t-test and the chi(2) test (p<0.05).

RESULTS

Some 82.8% of group A patients had previous HBV infection, whereas only 22.2% of group B patients did (p<0.001). Among group A patients, 10.3% were HBV-seronegative whereas 61.1% of group B patients were (p<0.001). Only 3.4% of group A patients were HBV-vaccinated compared to 16.7% in group B (p=0.016). HCV genotype was not associated with HBV serological status. No significant differences were detected in age, sex, possible time of infection, HBV serological status, or HCV genotype among those with higher vs. lower total grading scores. Seventy-five percent of patients had mild or no detectable fibrosis unrelated to the possible period of infection, the HBV serological status, and the HCV genotype.

CONCLUSIONS

The serological profile of HBV infection is changing among Greek chronic HCV-infected IDUs, while the percentages of successfully HBV-vaccinated IDUs are relatively low. Severe liver disease is an uncommon finding in these patients, irrespective of the possible time of infection, the HBV serological status, and the HCV genotype.

摘要

背景

本研究旨在评估慢性丙型肝炎病毒(HCV)感染的注射吸毒者(IDU)的HBV感染血清学状态和肝脏组织学,并将其与可能的感染时间和主要HCV基因型相关联。

方法

连续评估约130例先前感染慢性HCV的IDU的HBV感染血清学状态。58例(44.62%)报告1992年前开始静脉吸毒(A组),72例(55.38%)在1992年后开始(B组)。86例患者可进行HCV基因分型(PCR)。48例患者进行了肝活检(Ishak评分系统)。研究人群中没有关于饮酒的可用数据。统计分析基于t检验和卡方检验(p<0.05)。

结果

A组患者中约82.8%曾有HBV感染,而B组患者中只有22.2%有过HBV感染(p<0.001)。A组患者中,10.3%为HBV血清学阴性,而B组患者中61.1%为HBV血清学阴性(p<0.001)。A组患者中只有3.4%接种过HBV疫苗,而B组为16.7%(p=0.016)。HCV基因型与HBV血清学状态无关。在总分级评分较高和较低的患者中,年龄、性别、可能的感染时间、HBV血清学状态或HCV基因型均未检测到显著差异。75%的患者有轻度或无可检测到的纤维化,与可能的感染时期、HBV血清学状态和HCV基因型无关。

结论

希腊慢性HCV感染的IDU中HBV感染的血清学特征正在发生变化,而成功接种HBV疫苗的IDU比例相对较低。无论可能的感染时间、HBV血清学状态和HCV基因型如何,这些患者中严重肝病并不常见。

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