Ma Jian-Xin, Lu Hong-Zhou, Wang Jiang-Rong, Zhang Ren-Fang, Zheng Yu-Fang, Liu Li, Qi Tang-Kai, Shen Yin-Zhong
Department of Infectious Disease, Shanghai Public Health Clinical Center, Public Health Clinical Center Affiliated to Fudan University, Shanghai 201508, China.
Zhonghua Nei Ke Za Zhi. 2008 Jul;47(7):574-7.
Occult HBV infection is defined by positive HBV DNA in individuals with undetectable levels of HBsAg. The objective of this study was to assess the prevalence of occult HBV infection in HIV-infected patients.
Serum samples were obtained from 105 HBsAg-negative HIV patients who were hospitalized and were not given anti-virus treatment at Shanghai Public Health Clinical Center. Microparticle enzyme immunoassay (MEIA) was used to detect HBV serologic markers (HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc). ELISA was used to detect HCV antibody. CD4+ T cell count was examined with flow cytometry. Nested PCR was used to amplify surface protein region of HBV.
32 (30.5%) patients (27 men, 5 women) were HBV DNA positive in the 105 HBsAg-negative HIV-infected patients (92 men and 13 women). 22 patients (including 5 patients with HBV DNA +) were in 16-30 years group, 44 patients (including 15 patients with HBV DNA +) were in 3149 years group and 39 patients (including 12 patients with HBV DNA +) were in 50-75 years group. 5 patients were negative for all HBV serologic markers and 27 patients detected with at least one of anti-HBc, anti-HBe or anti-HBs. 14 patients (29.8%) with HBV DNA + in 47 HIV-infected patients were coinfected with HCV, 18 patients (31.0%) were HBV DNA + in 58 HIV-monoinfected patients. The median absolute CD4+ T cell count was 145.1 cells/microl (4-623 cells/microl), 26 patients (34.7%) were HBV DNA + in 75 AIDS patients with CD4+ T cell <200 cells/microl and 6 patients (20.0%) HBV DNA + in 30 HIV-infected patients with CD4+ T cell >200 cells/microl. No statistical significant association could be established between the above factors.
It is found that occult HBV did occur in HIV-infected patients. No statistical significant association could be established between occult HBV infection and gender, age, HBV serologic markers, coinfected HCV and CD4+ T cell count.
隐匿性HBV感染定义为HBsAg水平检测不到但HBV DNA呈阳性的个体。本研究的目的是评估HIV感染患者中隐匿性HBV感染的患病率。
从上海公共卫生临床中心收治的105例HBsAg阴性且未接受抗病毒治疗的HIV患者中采集血清样本。采用微粒酶免疫分析（MEIA）检测HBV血清学标志物（HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc）。采用酶联免疫吸附测定（ELISA）检测HCV抗体。用流式细胞术检测CD4+T细胞计数。采用巢式聚合酶链反应（PCR）扩增HBV表面蛋白区域。
在105例HBsAg阴性的HIV感染患者（92例男性和13例女性）中，32例（30.5%）患者（27例男性，5例女性）HBV DNA呈阳性。22例患者（包括5例HBV DNA阳性患者）在16 - 30岁组，44例患者（包括15例HBV DNA阳性患者）在31 - 49岁组，39例患者（包括12例HBV DNA阳性患者）在50 - 75岁组。5例患者所有HBV血清学标志物均为阴性，27例患者检测到抗-HBc、抗-HBe或抗-HBs中的至少一种。47例HIV感染患者中14例（29.8%）HBV DNA阳性患者合并感染HCV，58例HIV单感染患者中18例（31.0%）HBV DNA阳性。CD4+T细胞绝对计数中位数为145.1个/微升（4 - 623个/微升），75例CD4+T细胞<200个/微升的AIDS患者中有26例（34.7%）HBV DNA阳性，30例CD4+T细胞>200个/微升的HIV感染患者中有6例（20.0%）HBV DNA阳性。上述因素之间未发现统计学显著关联。
发现HIV感染患者中确实存在隐匿性HBV感染。隐匿性HBV感染与性别、年龄、HBV血清学标志物、合并感染HCV及CD4+T细胞计数之间未发现统计学显著关联。
