Goldin R D, Fish D E, Hay A, Waters J A, McGarvey M J, Main J, Thomas H C
Department of Histopathology, St Mary's Hospital Medical School, London.
J Clin Pathol. 1990 Mar;43(3):203-5. doi: 10.1136/jcp.43.3.203.
Because the risk factors for human immunodeficiency virus (HIV) infection and hepatitis B (HBV) are similar and therefore coinfection is not uncommon, a detailed histological and immunohistochemical study of chronic hepatitis B infection in a group of 20 HIV positive Caucasian males (who did not have AIDS) and 30 HIV negative controls were undertaken. Using both the conventional histological classification and the Knodell histological activity index it was shown that HIV negative patients were more likely to have active disease and also more scarring than HIV positive patients. Hepatitis B surface antigen (HBsAg) expression was not significantly different between the two groups but expression of hepatitis Be antigen (HBeAg) and HBV-DNA polymerase was greater in those who were HIV positive. HIV positive patients are therefore more likely to have immunohistochemical markers of active viral replication, although histologically, liver disease is less severe. These findings have important implications for assessing the biopsy specimens in this group of patients and for treatment strategies aimed at improving their immune function.
由于人类免疫缺陷病毒（HIV）感染和乙型肝炎（HBV）的危险因素相似，因此合并感染并不罕见，我们对一组20名未患艾滋病的HIV阳性白种男性和30名HIV阴性对照者的慢性乙型肝炎感染进行了详细的组织学和免疫组织化学研究。采用传统组织学分类和Knodell组织学活动指数显示，HIV阴性患者比HIV阳性患者更易患活动性疾病且瘢痕形成更多。两组之间乙型肝炎表面抗原（HBsAg）表达无显著差异，但HIV阳性者乙型肝炎e抗原（HBeAg）和HBV-DNA聚合酶的表达更高。因此，HIV阳性患者更有可能具有活跃病毒复制的免疫组织化学标志物，尽管从组织学上看，肝脏疾病不太严重。这些发现对于评估该组患者的活检标本以及旨在改善其免疫功能的治疗策略具有重要意义。
