定量纵向评估乙型肝炎 delta 病毒 RNA 和乙型肝炎病毒 DNA 显示慢性乙型肝炎和乙型肝炎 D 中存在动态、复杂的复制特征。

Quantitative longitudinal evaluations of hepatitis delta virus RNA and hepatitis B virus DNA shows a dynamic, complex replicative profile in chronic hepatitis B and D.

机构信息

Department of Biochemistry, Hospital Universitario Vall d'Hebron, Barcelona 08035, Spain.

出版信息

J Hepatol. 2010 May;52(5):658-64. doi: 10.1016/j.jhep.2009.10.036. Epub 2010 Mar 5.

DOI:10.1016/j.jhep.2009.10.036

PMID:20346531

Abstract

BACKGROUND & AIMS: This study presents a real-time reverse-transcription PCR (rt-RT-PCR) assay for hepatitis delta virus (HDV) RNA quantification, designed to clarify the interplay between HDV and hepatitis B virus (HBV) in chronic infection.

METHODS

Serum HDV-RNA and HBV-DNA were analysed by rt-RT-PCR in a cross-sectional study of 37 untreated chronic HDV patients, 25 of whom were also longitudinally studied.

RESULTS

In the cross-sectional study, both viruses were active in 15 (40.5%) patients and inactive in 4 (10.8%); HDV alone was active in 12 (32.4%) and HBV in 6 (16.2%). The longitudinal study showed seven replication profiles, with considerable fluctuating activity of one or both viruses, including alternating predominance. In 20% of cases, longitudinal HBV/HDV viral loads differed from cross-sectional results, indicating a risk of misinterpreting HBV/HDV interactions when assessing a single determination. Fluctuating HBV replication only increased in the presence of fluctuating HDV activity. HBsAg levels, stable in HBV single infection, fluctuated in HDV chronic infection. The results of both the cross-sectional and longitudinal study call into question the major suppressor effect of HDV over HBV, revealing an important role of HBV.

CONCLUSIONS

Longitudinal evaluation of viremia shows a complex interaction between HBV and HDV and is essential to understand the pathophysiology of chronic HDV infection.

摘要

背景与目的

本研究提出了一种实时逆转录聚合酶链反应（rt-RT-PCR）检测方法，用于定量检测乙型肝炎病毒（HBV）和丁型肝炎病毒（HDV）RNA，旨在阐明慢性感染中 HDV 与 HBV 之间的相互作用。

方法

采用 rt-RT-PCR 法对 37 例未经治疗的慢性 HDV 患者的血清 HDV-RNA 和 HBV-DNA 进行检测，其中 25 例患者进行了纵向研究。

结果

在横断面研究中，15 例（40.5%）患者同时存在两种病毒的活性，4 例（10.8%）患者两种病毒均无活性；12 例（32.4%）患者单独存在 HDV 活性，6 例（16.2%）患者单独存在 HBV 活性。纵向研究显示存在七种复制谱，其中一种或两种病毒的活性均存在明显波动，包括交替占主导地位。在 20%的病例中，纵向 HBV/HDV 病毒载量与横断面结果不同，表明在评估单次测定结果时，可能会误解 HBV/HDV 相互作用。仅在 HDV 活性波动的情况下，HBV 复制才会增加。在 HDV 慢性感染中，HBsAg 水平在 HBV 单一感染中稳定，而在 HDV 慢性感染中波动。横断面和纵向研究的结果均对 HDV 对 HBV 的主要抑制作用提出了质疑，揭示了 HBV 的重要作用。