Crespo J, Lozano J L, López-Arias M J, Martín-Ramos L, Sánchez-Antolín G, Dueñas C, Pons Romero F
Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Facultad de Medicina, Santander.
Med Clin (Barc). 1994 Nov 5;103(15):561-6.
Viral replication is one of the determining factors of the natural history of infection by the hepatitis B virus (HBV). The clinical significance of the viremia and the DNA-HBV findings in mononuclear cells was therefore analyzed.
The epidemiologic history, liver function tests and the Knodell index were analyzed in 117 patients with chronic hepatitis B (CHB) and 33 healthy HBV carriers. The DNA-HBV was studied in serum and mononuclear cells by dot-blot and polymerase chain reaction (PCR).
The DNA-HBV was detected by dot-blot in 62/117 subjects with and in CHB 3/33 healthy carriers. Viremis was determined by PCR in 107/117 patients with CHB and in 22/23 healthy carriers. Both aspartate aminotransferase (AST) as well as alanine aminotransferase (ALT) and the Knodell index were greater in the patients with positive DNA-HBV dot-blot. No significant differences were observed in the liver function tests and Knodell index with regard to the viremia detectable exclusively by PCR. In the mononuclear cells of peripheral blood, DNA-HBV was observed in 62% by dot-blot and in 95% by PCR. The presence of DNA-HBV by dot-blot in these cells was associated to greater disease activity.
The activity of chronic hepatitis B was correlated with the presence of high viremic levels with no direct relation being observed between low grade viremia and disease aggressivity. The finding of DNA-HBV by dot-blot in mononuclear cells was associated with a greater activity of chronic hepatitis B, with these results being in agreement with the serologic data reported.
病毒复制是乙肝病毒(HBV)感染自然史的决定性因素之一。因此,分析了病毒血症及单核细胞中HBV DNA检测结果的临床意义。
分析了117例慢性乙型肝炎(CHB)患者和33例健康HBV携带者的流行病学史、肝功能检查及Knodell指数。采用斑点杂交和聚合酶链反应(PCR)检测血清和单核细胞中的HBV DNA。
斑点杂交法在117例CHB患者中的62例及33例健康携带者中的3例检测到HBV DNA。PCR法检测出117例CHB患者中的107例及23例健康携带者中的22例存在病毒血症。斑点杂交法检测HBV DNA阳性患者的天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)及Knodell指数均较高。仅通过PCR检测到病毒血症的患者,其肝功能检查及Knodell指数无显著差异。外周血单核细胞中,斑点杂交法检测到HBV DNA的比例为62%,PCR法为95%。斑点杂交法检测到这些细胞中存在HBV DNA与更高的疾病活动度相关。
慢性乙型肝炎的活动与高病毒血症水平相关,低水平病毒血症与疾病侵袭性之间未观察到直接关系。斑点杂交法在单核细胞中检测到HBV DNA与慢性乙型肝炎的更高活动度相关,这些结果与报道的血清学数据一致。