Ansari Nastaran, Makvandi Manochehr, Samarbaf-Zadeh Ali Reza
Department of Virology, Tehran University of Medical Sciences, Tehran, IR Iran.
Department of Virology, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, IR Iran.
Jundishapur J Microbiol. 2015 Jan 14;8(3):e14571. doi: 10.5812/jjm.14571. eCollection 2015 Mar.
Hepatitis B virus (HBV) infection is a worldwide public health problem. Nine HBV genotypes (A-I) have been already discovered. HBV genotypes are important both in the clinical manifestation of disease and treatment response. Moreover, HBV DNA without HBs (Hepatitis B surface)-antigenemia was detected in some patients with chronic hepatitis (occult hepatitis). There is little information about HBV genotypes and its relation to occult infection despite the importance of this infection in Khuzestan Province.
This study aimed to determine both occult hepatitis B infection and HBV genotypes among cirrhotic patients.
Thirty-eight patients with liver cirrhosis, including 11 (28.9%) HBsAg-positive patients and 27 (71.1%) patients with cryptogenic cirrhosis participated in this study. The mean age of the patients at the time of cirrhosis diagnosis was 54.85 years (range 26-75 years). All patients were anti-HCV and anti-HIV negative. For all the samples, the serological Enzyme-Linked Immunosorbent Assay (ELISA) was performed for HBV markers including HBsAg, HBcAb, HBeAg, HBeAb tests. The common primer of S region of HBV was used for Nested PCR. The PCR products of the positive individuals were sequenced for genotyping and subtyping of HBV.
Eleven (40.7%) out of 27 HBV cryptogenic cirrhosis and all 11 HBsAg-positive patients were positive for HBV DNA. The seroprevalences of Hepatitis B virus HBe antigen, anti-HBe and anti-HBc antibodies among the cryptogenic cirrhosis patients were 5 (18.5%), 1 (3.7%), and 5 (20.83), and among HBsAg-positive patients were 6 (54.5%), 5 (45.5%), and 7 (63.6%), respectively.
In our study, only HBV genotype D was found among all the positive HBsAg and occult HBV infection. Moreover, high prevalence (40.7%) of occult HBV infection was determined among patients suffered from cryptogenic cirrhosis.
乙型肝炎病毒（HBV）感染是一个全球性的公共卫生问题。已经发现了9种HBV基因型（A - I）。HBV基因型在疾病的临床表现和治疗反应中都很重要。此外，在一些慢性肝炎患者（隐匿性肝炎）中检测到了无乙肝表面抗原血症的HBV DNA。尽管这种感染在胡齐斯坦省很重要，但关于HBV基因型及其与隐匿性感染的关系的信息却很少。
本研究旨在确定肝硬化患者中的隐匿性乙型肝炎感染和HBV基因型。
38例肝硬化患者参与了本研究，其中包括11例（28.9%）HBsAg阳性患者和27例（71.1%）隐源性肝硬化患者。肝硬化诊断时患者的平均年龄为54.85岁（范围26 - 75岁）。所有患者抗丙型肝炎病毒和抗人类免疫缺陷病毒均为阴性。对所有样本进行血清学酶联免疫吸附测定（ELISA），检测HBV标志物，包括HBsAg、HBcAb、HBeAg、HBeAb检测。使用HBV S区通用引物进行巢式PCR。对阳性个体的PCR产物进行测序，以进行HBV基因分型和亚型分析。
27例HBV隐源性肝硬化患者中有11例（40.7%）以及所有11例HBsAg阳性患者的HBV DNA呈阳性。隐源性肝硬化患者中乙肝病毒HBe抗原、抗HBe和抗HBc抗体的血清流行率分别为5例（18.5%）、1例（3.7%）和5例（20.83%），HBsAg阳性患者中分别为6例（54.5%）、5例（45.5%）和7例（63.6%）。
在我们的研究中，所有HBsAg阳性和隐匿性HBV感染患者中仅发现了HBV基因型D。此外，在隐源性肝硬化患者中确定了较高的隐匿性HBV感染率（40.7%）。
