Naoumov N V, Schneider R, Grötzinger T, Jung M C, Miska S, Pape G R, Will H
Clinic of Gastroenterology, Medical Academy, Sofia, Bulgaria.
Gastroenterology. 1992 Feb;102(2):538-43. doi: 10.1016/0016-5085(92)90101-4.
The type of hepatitis B virus ("wild-type" or precore mutant) in anti-e antigen antibody-positive carriers, viral DNA levels in the serum, and core and e antigen expression in the liver were investigated to search for a possible correlation of these factors with the severity of liver damage. Two major groups of patients were found: the patients in group A were predominantly infected with precore mutant virus and had chronic active hepatitis, expressed nuclear/cytoplasmic core and e antigens in liver biopsy specimens, and usually had high levels of viral DNA in their serum; patients in group B were infected with a mixture of wild-type and mutant viruses, had predominantly chronic persistent hepatitis, showed weaker expression of nuclear core antigen with no cytoplasmic core or e antigen, and had low viremia. A few patients were infected with viruses without precore stop-codon mutation. These data indicate a high prevalence of precore mutant viruses in anti-e carriers with chronic liver disease and suggest that monitoring of virus sequence type and DNA level may be of prognostic value for liver disease sequelae.
对e抗原抗体阳性携带者的乙型肝炎病毒类型（“野生型”或前核心突变体）、血清中的病毒DNA水平以及肝脏中的核心抗原和e抗原表达进行了研究，以寻找这些因素与肝损伤严重程度之间可能存在的相关性。发现了两大类患者：A组患者主要感染前核心突变病毒，患有慢性活动性肝炎，在肝活检标本中表达核/细胞质核心抗原和e抗原，血清中病毒DNA水平通常较高；B组患者感染野生型和突变病毒的混合物，主要患有慢性持续性肝炎，核核心抗原表达较弱，无细胞质核心抗原或e抗原，病毒血症水平较低。少数患者感染了无前核心终止密码子突变的病毒。这些数据表明，慢性肝病的e抗原抗体阳性携带者中前核心突变病毒的患病率很高，并表明监测病毒序列类型和DNA水平可能对肝病后遗症具有预后价值。
