中国人群中乙型肝炎病毒和丙型肝炎病毒合并感染患者的复制抑制情况
Replication Inhibition of Hepatitis B Virus and Hepatitis C Virus in Co-Infected Patients in Chinese Population.
作者信息
Yu Ge, Chi Xiumei, Wu Ruihong, Wang Xiaomei, Gao Xiuzhu, Kong Fei, Feng Xiangwei, Gao Yuanda, Huang Xinxing, Jin Jinglan, Qi Yue, Tu Zhengkun, Sun Bing, Zhong Jin, Pan Yu, Niu Junqi
机构信息
Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China.
Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin Province, China; Key Laboratory of Zoonosis Research, Ministry Education, Jilin University, Changchun, Jilin, China; Jilin Province Key Laboratory of Infectious Diseases, Laboratory of Molecular Virology, Changchun, Jilin Province, China.
出版信息
PLoS One. 2015 Sep 30;10(9):e0139015. doi: 10.1371/journal.pone.0139015. eCollection 2015.
BACKGROUND
Hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infections contributes to a substantial proportion of liver disease worldwide. The aim of this study was to assess the clinical and virological features of HBV-HCV co-infection.
METHODS
Demographic data were collected for 3238 high-risk people from an HCV-endemic region in China. Laboratory tests included HCV antibody and HBV serological markers, liver function tests, and routine blood analysis. Anti-HCV positive samples were analyzed for HCV RNA levels and subgenotypes. HBsAg-positive samples were tested for HBV DNA.
RESULTS
A total of 1468 patients had chronic HCV and/or HBV infections. Among them, 1200 individuals were classified as HCV mono-infected, 161 were classified as HBV mono-infected, and 107 were classified as co-infected. The HBV-HCV co-infected patients not only had a lower HBV DNA positive rate compared to HBV mono-infected patients (84.1% versus 94.4%, respectively; P < 0.001). The median HCV RNA levels in HBV-HCV co-infected patients were significantly lower than those in the HCV mono-infected patients (1.18[Interquartile range (IQR) 0-5.57] versus 5.87[IQR, 3.54-6.71] Log10 IU/mL, respectively; P < 0.001). Furthermore, co-infected patients were less likely to have detectable HCV RNA levels than HCV mono-infected patients (23.4% versus 56.5%, respectively; P < 0.001). Those HBV-HCV co-infected patients had significantly lower median HBV DNA levels than those mono-infected with HBV (1.97[IQR, 1.3-3.43] versus 3.06[IQR, 2-4.28] Log10 IU/mL, respectively; P < 0.001). The HBV-HCV co-infection group had higher ALT, AST, ALP, GGT, APRI and FIB-4 levels, but lower ALB and total platelet compared to the HBV mono-infection group, and similar to that of the HCV mono-infected group.
CONCLUSION
These results suggest that co-infection with HCV and HBV inhibits the replication of both viruses. The serologic results of HBV-HCV co-infection in patients suggests more liver injury compared to HBV mono-infected patients, but is similar to HCV mono-infection.
背景
乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）合并感染在全球范围内导致了相当比例的肝脏疾病。本研究旨在评估HBV-HCV合并感染的临床和病毒学特征。
方法
收集了来自中国一个HCV流行地区的3238名高危人群的人口统计学数据。实验室检测包括HCV抗体和HBV血清学标志物、肝功能检测和血常规分析。对抗-HCV阳性样本分析HCV RNA水平和基因亚型。对HBsAg阳性样本检测HBV DNA。
结果
共有1468例患者患有慢性HCV和/或HBV感染。其中，1200例被分类为HCV单感染，161例被分类为HBV单感染，107例被分类为合并感染。与HBV单感染患者相比，HBV-HCV合并感染患者的HBV DNA阳性率较低（分别为84.1%和94.4%；P<0.001）。HBV-HCV合并感染患者的HCV RNA水平中位数显著低于HCV单感染患者（分别为1.18[四分位间距（IQR）0-5.57]和5.87[IQR，3.54-6.71] Log10 IU/mL；P<值0.001）。此外，合并感染患者的HCV RNA可检测水平低于HCV单感染患者（分别为23.4%和56.5%；P<0.001）。那些HBV-HCV合并感染患者的HBV DNA水平中位数显著低于HBV单感染患者（分别为1.97[IQR，1.3-3.43]和3.06[IQR，2-4.28] Log10 IU/mL；P<0.001）。与HBV单感染组相比，HBV-HCV合并感染组的ALT、AST、ALP、GGT、APRI和FIB-4水平较高，但ALB和总血小板较低，与HCV单感染组相似。
结论
这些结果表明，HCV和HBV合并感染会抑制两种病毒的复制。患者中HBV-HCV合并感染的血清学结果表明，与HBV单感染患者相比，肝脏损伤更严重，但与HCV单感染相似。
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