摘要
目的探讨核苷(酸)类似物对乙肝患者肝细胞内HBV cccDNA、tDNA及血清HBsAg影响。方法应用荧光定量聚合酶链反应法检测4例核苷(酸)类似物抗病毒治疗的慢性乙肝患者(疗程>2年并达到《慢性乙肝防治指南》停药标准)和12例未进行抗病毒治疗且血清HBV DNA<1.0×103copies/ml的慢性乙肝患者肝细胞内HBVcccDNA、tDNA和血清HBV DNA水平;ELISA法检测上述患者血清HBsAg水平,分析核苷(酸)类似物对患者体内HBV病毒学指标的影响。结果 4例抗病毒治疗患者达到停药标准时,肝细胞内HBV cccDNA、tDNA水平及血清Hb-sAg水平较未进行抗病毒治疗患者明显降低,但肝细胞内仍然可以检出低载量HBV cccDNA;4例患者分别随访至停药后9、12、19、19个月,均未反弹。结论 (1)核苷(酸)类似物抗病毒治疗可耗竭肝细胞内的HBV cccDNA并伴随肝细胞tDNA、血清HBsAg水平下降。(2)核苷(酸)类似物抗病毒治疗达到我国《慢性乙肝防治指南》停药标准的患者肝细胞内可检出低载量的HBV cccDNA,停药后仍有复发的可能。
Objective To study the influences of nucleoside analogue on hepatitis B virus （HBV） cccDNA, tDNA and serum HbsAg in chronic hepatitis B （CHB） patients. Methods The levels of hepatocellular cccDNA, tDNA, and serum HBV DNA were determined in four CHD patients who were treated by nucleoside analogue antiviral therapy and met the drug with-drawal criteria （ NAAT group） and in 12 CHB patients who did not receive any antiviral therapy with HBV DNA being 1.0 × 10^3 copies/ml （ control group）. The level of HbsAg was determined using enzyme linked immunosorbent assay （ ELISA）, and the in- fluences of nucleoside analogue on HBV viral indexes was analyzed. Results The levels of hepatocellular cccDNA, tDNA, andserum HBV DNA were significantly lower in the NAAT group than in control group, although low level of HBV cccDNA was still detected in hepatic ceils. No relapse was noted in the NAAT group 9, 12, 19, and 19 months after drug withdrawal. Conclu- sion Long - term nucleoside analogue therapy may consume hepatocellular cccDNA and contribute to the decrease of hepatocellu-lar tDNA and serum HBsAg. In patients who meet the drug withdrawal criteria for CHB, low level of HBVcccDNA can still be detected in hepatocytes even after 2 years＇ nueleoside analogue therapy, and cessation of therapy may cause relapse.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第8期865-867,共3页
Chinese General Practice
基金
广西自然科学基金(2010GXNSFD013046
桂科自0832117
桂科自0542092
桂科青0832037)
广西医学科学实验中心开放基金资助项目(KFJJ2010-20)
关键词
肝炎
乙型
慢性
核苷类
核苷酸类
聚合酶链反应
Hepatitis B, chronic
Nucleosides
Nucleotides
Polymerase chain reaction
