Lau G K, Wu P C, Liang R, Yuen S T, Lim W L
University Department of Medicine, Queen Mary Hospital, Hong Kong.
J Clin Pathol. 1997 Aug;50(8):706-8. doi: 10.1136/jcp.50.8.706.
Delayed clearance of hepatitis B surface antigen was previously reported in a 38 year old woman after high dose chemotherapy with autologous peripheral blood stem cell rescue. Sixteen months later, this patient remained hepatitis B surface antigen negative, hepatitis B surface antibody positive, and serum hepatitis B DNA negative by polymerase chain reaction. Serial liver biopsies (one at hepatitis B e antigen positive stage, one at hepatitis B e antibody positive stage, and one at hepatitis B surface antigen negative and hepatitis B surface antibody positive stage) showed a gradual resolution of the inflammatory activity with loss of hepatitis B e antigen and then hepatitis B surface antigen in the serum. However, the degree of fibrosis, though mild, remained the same. With the serological clearance of hepatitis B surface antigen, a small amount of hepatitis B virus DNA was still detectable in the nuclei of liver cells.
先前有报道称，一名38岁女性在接受大剂量化疗及自体外周血干细胞救援后，乙肝表面抗原清除延迟。16个月后，该患者乙肝表面抗原仍为阴性，乙肝表面抗体为阳性，血清乙肝DNA经聚合酶链反应检测为阴性。系列肝脏活检（一次在乙肝e抗原阳性阶段，一次在乙肝e抗体阳性阶段，一次在乙肝表面抗原阴性且乙肝表面抗体阳性阶段）显示，炎症活动逐渐消退，血清中乙肝e抗原及随后的乙肝表面抗原消失。然而，纤维化程度虽轻微，但保持不变。随着乙肝表面抗原的血清学清除，仍可在肝细胞细胞核中检测到少量乙肝病毒DNA。
