Wood J R, Taswell H F, Czaja A J, Rabe D
Department of Medicine, Mayo Clinic, Rochester, Minnesota 55905.
Dig Dis Sci. 1988 Apr;33(4):477-80. doi: 10.1007/BF01536035.
To determine the pattern and duration of HBV DNA seropositivity in acute hepatitis B, six patients were assessed during the incubation, clinical, and convalescent stages of their illness by DNA hybridization using a slot blot technique. Patients were identified by the detection of HBsAg nearly one month before the development of clinical and laboratory features of acute hepatitis (mean 22 +/- 4 days) and they were followed at one- to three-week intervals for 6 +/- 1 months. Each patient lacked antibody to delta virus. During the incubation period, HBV DNA was not detected in serum. At symptomatic onset, all were seropositive for HBV DNA and HBeAg. At peak biochemical disease, three patients had already cleared HBV DNA and five continued to harbor HBeAg. The duration of HBV DNA seropositivity was as short as one week. At the time of biochemical resolution, all patients had cleared HBV DNA, while four of five remained HBeAg-positive. Clearance of HBeAg and HBsAg occurred 4 +/- 2 months after loss of HBV DNA. We conclude that HBV DNA is not detectable in serum during the early incubation period but that it is present at the onset of symptoms. Its duration in serum can be brief and clearance is possible by the peak of aminotransferase activity. HBV DNA usually disappears before HBeAg, and it is invariably lost by the time of biochemical resolution. Its detection in serum coincides with the clinical illness, but it may be missed unless sampling is done early in the clinical course.
为确定急性乙型肝炎中HBV DNA血清阳性的模式和持续时间，采用狭缝印迹技术通过DNA杂交对6例患者在其疾病的潜伏期、临床期和恢复期进行了评估。患者在出现急性肝炎临床和实验室特征前近1个月（平均22±4天）检测到HBsAg而被识别，并以1至3周的间隔随访6±1个月。每位患者均缺乏丁型病毒抗体。在潜伏期，血清中未检测到HBV DNA。出现症状时，所有患者的HBV DNA和HBeAg均为血清阳性。在生化指标疾病高峰期，3例患者已清除HBV DNA，5例患者仍携带HBeAg。HBV DNA血清阳性的持续时间短至1周。在生化指标恢复时，所有患者均已清除HBV DNA，而5例中有4例HBeAg仍为阳性。HBeAg和HBsAg在HBV DNA消失后4±2个月清除。我们得出结论，在早期潜伏期血清中检测不到HBV DNA，但在症状出现时存在。其在血清中的持续时间可能很短暂，在转氨酶活性达到峰值时可能清除。HBV DNA通常在HBeAg之前消失，在生化指标恢复时必然消失。其在血清中的检测与临床疾病相符，但除非在临床病程早期进行采样，否则可能会漏检。
