摘要
目的 探讨HBsAg/HBsAb双阳患者和HBsAg单阳性患者的血清学差异,并对两组患者的HBV S区突变位点进行比较分析,探寻HBsAg/HBsAb共阳性患者可能的分子机制.方法 选取首都医科大学附属北京佑安医院2022年6月至2023年3月的284例HBsAg/HBsAb双阳患者和519例HBsAg单阳患者,统计Age、ALT、AST、AST/ALT、TBiL、ALb、r-GT、HBsAg和HBsAg滴度、HBsAb、HBeAg、HBeAb、HBcAb、WBC,对两组患者的血清学指标进行比较分析.对HBV S区扩增成功的19例HBsAg/HBsAb双阳患者和19例HBsAg单阳患者进行测序分析,统计高频突变位点,分析HBV S区突变特征,探寻HBsAg/HBsAb双阳患者可能发生的分子机制.结果 HBsAg/HBsAb双阳患者和HBsAg单阳患者在性别、HBeAg、ALT、AST、TBiL、r-GT差异有统计学意义(P<0.05).两组患者在Age、HBeAb、HBcAb、AST/ALT、Alb、WBC差异无统计学意义(P>0.05).HBsAg/HBsAb双阳组患者C基因型占78.95％(15/19),其中A113D/T、A317C/S、A45T、A86G、A87T、A96V、A97P等突变频率较高,HBsAg单阳组C基因型占84.21％(16/19),V159A、M47T、I213L、A317S、E44G、Q267L突变频率较高,两组患者的高频突变位点明显不同.结论 双阳和单阳CHB患者血清学和基因突变位点存在显著差异.建议针对HBV S区不同的突变位点进一步研究HBsAg和HBsAb共存的机制.
Abstract
Objective To explore the serological differences between HBsAg/HBsAb double-positive patients and HBsAg single-positive patients,and to compare and analyze HBV S-region mutation sites between the two groups of patients,and to further uncover the underlying molecular mechanisms in HBsAg/HBsAb co-positive patients.Methods A total of 284 HBsAg/HBsAb double-positive patients and 519 HBsAg single-positive patients from Beijing Youan Hospital affiliated with Capital Medical University from June, 2021 to March,2023 were selected for the study.Age,ALT,AST,AST/ALT,TBiL,ALb,r-GT,HBsAg and HBsAg titer,as well as HBsAb,HBeAg,HBeAb,HBcAb and WBC were statistically analyzed,and the serological indexes of the two groups were then compared.Nineteen HBsAg/HBsAb double-positive patients and 19 HBsAg single-positive patients with successful amplification of HBV S region were sequenced and analyzed,and high-frequency mutation sites were counted to evaluate the characteristics of the mutations in the HBV S region,and to further identify the molecular mechanisms in HBsAg/HBsAb double-positive patients.Results HBsAg/HBsAb double-positive patients and HBsAg single-positive patients showed significant differences in gender,HBeAg,ALT,AST,TBiL,r-GT (P<0.05).There was no significant difference in age,HBeAb,HBcAb,AST/ALT,Alb and WBC between the two groups (P>0.05).The C genotype of HBsAg/HBsAb double-positive group accounted for 78.95％ (15/19),among which the mutation frequency of A113D/T,A317C/S,A45T,A86G,A87T,A96V,A97P were higher,and the C genotype of HBsAg single-positive group accounted for 84.21％ (16/19 ).The mutation frequencies of V159A,M47T,I213L,A317S,E44G and Q267L were higher,and the high-frequency mutation sites of the two groups were significantly different.Conclusion There are significant differences in serological and genetic mutation sites between double-positive and single-positive CHB patients.It is recommended to further investigate the underlying mechanism of co-existence of HBsAg and HBsAb by targeting different mutation sites in HBV S region.
基金项目
国家科技重大专项(2018ZX10305-410-006)
北京市优秀人才项目(2018000021469G287)
首都医科大学附属北京佑安医院中青年人才孵育项目(BJYAYY-CY2019-11)
首都卫生发展科学研究专项公共卫生项目(2021-1G-4302)
维普
万方数据