在血清中通过聚合酶链反应未检测到可证实的HBV DNA的患者中，抗HBe阳性慢性乙型肝炎频繁复发。

Frequent reactivations of anti-HBe-positive chronic hepatitis B in patients with no demonstrable HBV DNA in serum by polymerase chain reaction.

作者信息

Lee H S, Yoon J H, Kim C Y

机构信息

Department of Internal Medicine, Seoul National University College of Medicine, Korea.

出版信息

Korean J Intern Med. 1995 Jul;10(2):103-7. doi: 10.3904/kjim.1995.10.2.103.

DOI:10.3904/kjim.1995.10.2.103

PMID:7495767

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4532045/

Abstract

OBJECTIVES

The present study was conducted to evaluate the prognostic significance of the absence of serum HBV DNA by polymerase chain reaction (PCR) after spontaneous HBeAg/anti-HBe seroconversion and concurrent or subsequent biochemical remission.

METHODS

We prospectively investigated the reactivation rates in 28 chronic hepatitis B patients according to the positive or negative serum HBV DNA test by PCR. The sera drawn at a mean period of 4.4 months after normalization of alanine aminotransferase (ALT) were analyzed by PCR-Southern blot hybridization to detect HBV DNA, and then the patients were divided into two groups according to the presence (n = 14) or absence (n = 14) of HBV DNA in the sera.

RESULTS

The cumulative reactivation rates in patients with HBV DNA in sera were 43%, 57%, 57%, 57% and 57% at the end of 1st, 2nd, 3rd, 4th and 5th year after normalization of ALT, respectively, and those in patients without demonstrable HBV DNA were 50%, 66%, 74%, 74% and 83%, respectively; thus, the difference in the cumulative reactivation rates between patients with and without serum HBV DNA was not statistically significant (p = 0.79), and irrespective of the status of HBV DNA in sera by PCR, reactivations occurred very rarely after 2 years of a sustained remission.

CONCLUSIONS

We conclude that the seroconversion to anti-HBe accompanied by disappearance of serum HBV DNA even by PCR does not necessarily suggest a sustained remission of chronic hepatitis B.

摘要

目的

本研究旨在评估在HBeAg/抗-HBe自发血清学转换以及同时或随后出现生化缓解后，通过聚合酶链反应（PCR）检测血清中未检出乙肝病毒（HBV）DNA的预后意义。

方法

我们根据PCR检测血清HBV DNA呈阳性或阴性，对28例慢性乙型肝炎患者的再激活率进行了前瞻性研究。在丙氨酸氨基转移酶（ALT）恢复正常后平均4.4个月采集的血清，通过PCR- Southern印迹杂交分析以检测HBV DNA，然后根据血清中HBV DNA的存在情况（n = 14）或不存在情况（n = 14）将患者分为两组。

结果

血清中存在HBV DNA的患者在ALT恢复正常后第1、2、3、4和5年末的累积再激活率分别为43%、57%、57%、57%和57%，而未检测到HBV DNA的患者分别为50%、66%、74%、74%和83%；因此，血清中存在和不存在HBV DNA的患者之间的累积再激活率差异无统计学意义（p = 0.79），并且无论PCR检测血清中HBV DNA的状态如何，在持续缓解2年后很少发生再激活。