Kiyosawa K, Nakamura M, Sodeyama T, Tanaka E, Nakano Y, Furuta S
Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Jpn J Med. 1988 Aug;27(3):267-71. doi: 10.2169/internalmedicine1962.27.267.
Sera and biopsied liver specimens from 45 hepatitis B surface antigen (HBsAg) carriers both with or without overt liver diseases and negative for anti-delta antibody, were examined for markers of hepatitis B virus (HBV) infection: hepatitis B e antigen (HBeAg), hepatitis B virus deoxyribonucleic acid (HBV-DNA) in serum and hepatitis B core antigen (HBcAg) in liver. HBV-DNA in serum was assayed by the spot hybridization technique, and HBcAg in the liver was investigated by the peroxidase anti-peroxidase method. Among the parameters showing active replication of HBV, serum HBeAg, serum HBV-DNA and intrahepatic HBcAg were found in 27 (60%), 27 (60%) and in 22 (48.9%) of 45 HBsAg carriers, respectively. The presence of serum HBV-DNA and of intrahepatic HBcAg in HBeAg positive cases and the absence of serum HBV-DNA and of intrahepatic HBcAg in anti-HBe positive cases was the rule with few disparate cases among those with chronic liver disease. These parameters were not useful in predicting the histology on liver biopsy. The activity of hepatic inflammation in the HBsAg chronic carriers assessed by serum alanine aminotransferase level closely paralleled HBV-DNA in serum but not HBeAg in serum, HBcAg in liver or histologic picture on biopsy. HBV-DNA may be the most sensitive parameter of replication of hepatitis B virus and of the activity of inflammation in the liver.
对45例乙肝表面抗原（HBsAg）携带者的血清和肝脏活检标本进行了检测，这些携带者均无丁型肝炎抗体，且有无明显肝脏疾病。检测项目包括乙肝病毒（HBV）感染标志物：血清乙肝e抗原（HBeAg）、血清乙肝病毒脱氧核糖核酸（HBV-DNA）以及肝脏中的乙肝核心抗原（HBcAg）。血清HBV-DNA采用斑点杂交技术检测，肝脏中的HBcAg采用过氧化物酶抗过氧化物酶法检测。在显示HBV活跃复制的参数中，45例HBsAg携带者中分别有27例（60%）、27例（60%）和22例（48.9%）检测到血清HBeAg、血清HBV-DNA和肝内HBcAg。HBeAg阳性病例中血清HBV-DNA和肝内HBcAg的存在，以及抗-HBe阳性病例中血清HBV-DNA和肝内HBcAg的缺失是常见规律，慢性肝病患者中仅有少数不同情况。这些参数对预测肝脏活检的组织学表现并无帮助。通过血清丙氨酸转氨酶水平评估的HBsAg慢性携带者肝脏炎症活动与血清HBV-DNA密切相关，但与血清HBeAg、肝内HBcAg或活检的组织学图像无关。HBV-DNA可能是乙肝病毒复制及肝脏炎症活动最敏感的参数。
