乙肝病毒感染免疫耐受状态的早期终止可解释肝损伤。
Early termination of immune tolerance state of hepatitis B virus infection explains liver damage.
作者信息
Akbar Sheikh Mohammad Fazle, Uddin Helal, Khan Sakirul Islam, Rahman Salimur
机构信息
Mamun-Al-Mahtab, Salimur Rahman, Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000, Bangladesh.
出版信息
World J Hepatol. 2014 Aug 27;6(8):621-5. doi: 10.4254/wjh.v6.i8.621.
AIM
To assess an early termination of immune tolerance state of chronic hepatitis B virus infection in Bangladesh and its clinical significance.
METHODS
From a series of 167 treatment-naive chronic hepatitis B patients aged between 12 to 20 years (mean ± SD; 17.5 ± 2.8 years), percutaneous liver biopsies of 89 patients who were all hepatitis B e antigen negative at presentation were done. Of them, 81 were included in the study. They had persistently normal or raised serum alanine aminotransferase (ALT) values. A precore mutation (PCM) study was accomplished in 8 patients who were randomly selected.
RESULTS
Forty-four (53.7%) patients had significant necroinflammation (HAI-NI > 7), while significant fibrosis (HAI-F ≥ 3) was seen in 15 (18.5%) patients. Serum ALT (cut off 42 U/L) was raised in 29 (35.8%) patients, while low HBV DNA load (< 10(5) copies/mL) was observed in 57 (70.4%) patients. PCM was negative in all 8 patients.
CONCLUSION
This study indicates that the current concept of age-related immune tolerance state of HBV infection deserves further analyses in different population groups.
目的
评估孟加拉国慢性乙型肝炎病毒感染免疫耐受状态的早期终止情况及其临床意义。
方法
在167例初治慢性乙型肝炎患者（年龄12至20岁，平均±标准差；17.5±2.8岁）中，对89例初诊时乙肝e抗原均为阴性的患者进行经皮肝活检。其中，81例纳入研究。他们的血清丙氨酸氨基转移酶（ALT）值持续正常或升高。对随机选取的8例患者进行了前核心突变（PCM）研究。
结果
44例（53.7%）患者有显著坏死性炎症（HAI-NI>7），15例（18.5%）患者有显著纤维化（HAI-F≥3）。29例（35.8%）患者血清ALT（临界值42 U/L）升高，57例（70.4%）患者乙肝病毒DNA载量低（<10⁵拷贝/mL）。8例患者的PCM均为阴性。
结论
本研究表明，目前关于乙肝病毒感染与年龄相关的免疫耐受状态的概念在不同人群中值得进一步分析。
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