有乙型肝炎病毒感染史的自身免疫性肝炎患者的病毒学特征分析
Analysis of virological characteristics in autoimmune hepatitis patients with previous hepatitis virus B infection
陈欣欣 1张海萍 2黄春洋 3闫惠平2
作者信息
- 1. 100050,首都医科大学附属北京友谊医院临床检验中心;100069,首都医科大学附属北京佑安医院临床检验中心
- 2. 100069,首都医科大学附属北京佑安医院临床检验中心
- 3. 100069,首都医科大学附属北京佑安医院肝病中心二科
- 折叠
摘要
目的 探讨有乙型肝炎病毒(hepatitis virus B,HBV)感染史的自身免疫性肝炎(autoimmune hepartitis,AIH)患者的病毒学特征.方法 回顾性分析2012年8月—2022年8月北京佑安医院诊治的180例AIH患者的临床资料,比较有/无既往HBV感染AIH患者的实验室相关指标;利用巢式PCR和Real-time PCR进行HBV DNA检测,以确定AIH患者是否存在隐匿性HBV感染(occult HBV infection,OBI),并进一步明确其病毒学特征.结果 AIH患者中有HBV感染史者占38.89％(70/180).既往HBV感染组患者的抗核抗体(1∶320～1∶1000)的比例显著高于无HBV感染史组(x2=4.210,P=0.040).病毒学检测结果发现,27.27％(12/44)既往HBV感染的AIH患者中存在OBI;OBI患者HBV基因型为B、C型及B/C混合型;在HBV S区阅读框,C基因型的氨基酸突变位点数高于B基因型,B/C混合感染的患者具有更多的氨基酸突变位点;在主要亲水区发现多个免疫逃逸相关突变位点(如sT125A,sI126T等),截短突变位点(sC137*)和缺失突变位点(AAs 113～116).结论 有HBV感染史的AIH患者中存在OBI的可能.HBV S区部分氨基酸位点的突变,可能与OBI产生有关.
Abstract
Objective To investigate the virological characteristics of autoimmune hepatitis patients with previous hepatitis virus B (HBV) infection. Methods A total of 180 patients with autoimmune hepatitis ( AIH ) diagnosed in Beijing YouAn Hospital from August 2012 to August 2022 were retrospectively analyzed. The clinical characteristics and laboratory indicators were compared. The diagnosis of Occult HBV infection ( OBI ) was confirmed by nested PCR and Real-time PCR, and the virological characteristics were further studied. Results The prevalence of previous HBV infection in AIH patients was 38.89％ ( 70/180 ). The ratio of antinuclear antibody ( ANA ) ( 1∶320～1∶1000 ) in AIH patients with previous HBV infection was significantly higher than that in patients without previous HBV infection ( x2=4.210, P=0.040 ). The results of virological examination showed that OBI was present in 27.27％ ( 12/44 ) of AIH patients with previous HBV infection. The HBV genotypes of OBI patients were B, C and B/C mixed. In the reading frame of HBV S region, the amino acid mutation sites of C genotype were more than those of B genotype, and the number of amino acid mutation sites of B/C mixed infection was more than that of single genotype infection. Multiple immune escape associated mutation sites ( sT125A, sI126T, etc. ), truncated mutation sites ( sC137 ), and deleted mutation sites ( AAs 113～116 ) were found in major hydrophilic regions ( MHR ). Conclusions OBI may exist in AIH patients with previous HBV infection. The mutation of some amino acid sites in S region of HBV may be related to the cause of OBI.
关键词
自身免疫性肝炎/既往HBV感染/隐匿性HBV感染Key words
autoimmune hepatitis/previous HBV infection/occult HBV infection引用本文复制引用
基金项目
北京市自然科学基金(7111004)
北京市医管局培育项目(PX2019062)
出版年
2024
NETL
NSTL
万方数据