目的观察慢性乙肝病毒(HBV)感染者细胞免疫功能的变化,探讨病毒复制程度与细胞免疫功能的关系。方法应用流式细胞仪直接免疫荧光法检测230例乙肝病毒感染者5、0例正常对照外周血T细胞亚群百分率,用荧光定量PCR法检测乙肝感染者血清HBV ...目的观察慢性乙肝病毒(HBV)感染者细胞免疫功能的变化,探讨病毒复制程度与细胞免疫功能的关系。方法应用流式细胞仪直接免疫荧光法检测230例乙肝病毒感染者5、0例正常对照外周血T细胞亚群百分率,用荧光定量PCR法检测乙肝感染者血清HBV DNA。结果HBV感染者外周血CD4+T细胞百分率及CD4+/CD8+比值较正常对照组明显减低(36.8±10.6%vs 39.4±9.8%,P<0.05;1.5±0.8 vs 1.9±0.9,P<0.01),CD8+T细胞百分率明显升高(27.9±8.3%vs 24.1±7.0%,P<0.01),而CD3+T细胞百分率无明显差异(70.2±10.3%vs 69.9±5.2%,P>0.05)。根据HBV感染者血清中HVB DVA载量的高低,将它们分为低拷贝组(103-104copies/ml),高拷贝组(105-108copies/ml)以及DNA阴性组(<102copies/ml)。低拷贝组和高拷贝组的CD4+T细胞百分率及CD4+/CD8+比值比对照组明显减低(36.4±10.9%vs 39.4±9.8%,P<0.05;36.4±10.9%vs 39.4±9.8P<0.05;1.5±0.9 vs 1.9±0.9,P<0.01;1.1±0.7 vs 1.9±0.9,P<0.01),高拷贝组的CD4+/CD8+比值比低拷贝组和DNA阴性组明显减低(1.1±0.7 vs 1.5±0.9,P<0.01;1.1±0.7 vs 1.6±0.8,P<0.01),CD8+细胞百分率明显高于对照组和DNA阴性组(29.4±8.4%vs 24.1±7.0%,P<0.01;29.4±8.4%vs 25.7±7.3%vs 24.1±7.0%P<0.05)。而CD3+T细胞百分率在各组之间没有明显差异存在(P>0.05),CD4+在低、高拷贝组及DNA阴性组之间虽无明显差异存在(P>0.05),但随着DNA复制的增加,CD4+呈逐渐减少趋势。结论HBV感染可导致感染者细胞免疫功能的改变,HBA DNA复制增加进一步加重乙肝病毒感染者T细胞亚群的率乱,CD4+/CD8+比值的动态变化可及时提示临床HBV感染者细胞免疫功能的变化并加强临床的临测。展开更多
AIM:To investigate the current seroprevalence of hepatitis A virus(HAV) antibodies in patients with chronic viral liver disease in Korea.We also tried to identify the factors affecting the prevalence of HAV antibodies...AIM:To investigate the current seroprevalence of hepatitis A virus(HAV) antibodies in patients with chronic viral liver disease in Korea.We also tried to identify the factors affecting the prevalence of HAV antibodies. METHODS:We performed an analysis of the clinical records of 986 patients(mean age:49±9 years,714 males/272 females) with chronic hepatitis B virus(HBV) or hepatitis C virus(HCV) infection who had undergone HAV antibody testing between January 2008 and December 2009.RESULTS:The overall prevalence of IgG anti-HAV was 86.61%(854/986) in patients with chronic liver disease and was 88.13%(869/986) in age-and gendermatched patients from the Center for Health Promotion.The anti-HAV prevalence was 80.04%(405/506) in patients with chronic hepatitis B,86.96%(20/23) in patients with chronic hepatitis C,93.78%(422/450) in patients with HBV related liver cirrhosis,and 100%(7/7) in patients with HCV related liver cirrhosis.The anti-HAV prevalence according to the decade of age was as follows:20s(6.67%) ,30s(50.86%) ,40s(92.29%) ,50s(97.77%) ,and 60s(100%) .The antiHAV prevalence was significantly higher in patients older than 40 years compared with that in patients younger than 40 years of age.Multivariable analysis showed that age≥40 years,female gender and metropolitan cities as the place of residence were independent risk factors for IgG anti-HAV seropositivity. CONCLUSION:Most Korean patients with chronic liver disease and who are above 40 years of age have already been exposed to hepatitis A virus.展开更多
文摘目的观察慢性乙肝病毒(HBV)感染者细胞免疫功能的变化,探讨病毒复制程度与细胞免疫功能的关系。方法应用流式细胞仪直接免疫荧光法检测230例乙肝病毒感染者5、0例正常对照外周血T细胞亚群百分率,用荧光定量PCR法检测乙肝感染者血清HBV DNA。结果HBV感染者外周血CD4+T细胞百分率及CD4+/CD8+比值较正常对照组明显减低(36.8±10.6%vs 39.4±9.8%,P<0.05;1.5±0.8 vs 1.9±0.9,P<0.01),CD8+T细胞百分率明显升高(27.9±8.3%vs 24.1±7.0%,P<0.01),而CD3+T细胞百分率无明显差异(70.2±10.3%vs 69.9±5.2%,P>0.05)。根据HBV感染者血清中HVB DVA载量的高低,将它们分为低拷贝组(103-104copies/ml),高拷贝组(105-108copies/ml)以及DNA阴性组(<102copies/ml)。低拷贝组和高拷贝组的CD4+T细胞百分率及CD4+/CD8+比值比对照组明显减低(36.4±10.9%vs 39.4±9.8%,P<0.05;36.4±10.9%vs 39.4±9.8P<0.05;1.5±0.9 vs 1.9±0.9,P<0.01;1.1±0.7 vs 1.9±0.9,P<0.01),高拷贝组的CD4+/CD8+比值比低拷贝组和DNA阴性组明显减低(1.1±0.7 vs 1.5±0.9,P<0.01;1.1±0.7 vs 1.6±0.8,P<0.01),CD8+细胞百分率明显高于对照组和DNA阴性组(29.4±8.4%vs 24.1±7.0%,P<0.01;29.4±8.4%vs 25.7±7.3%vs 24.1±7.0%P<0.05)。而CD3+T细胞百分率在各组之间没有明显差异存在(P>0.05),CD4+在低、高拷贝组及DNA阴性组之间虽无明显差异存在(P>0.05),但随着DNA复制的增加,CD4+呈逐渐减少趋势。结论HBV感染可导致感染者细胞免疫功能的改变,HBA DNA复制增加进一步加重乙肝病毒感染者T细胞亚群的率乱,CD4+/CD8+比值的动态变化可及时提示临床HBV感染者细胞免疫功能的变化并加强临床的临测。
文摘AIM:To investigate the current seroprevalence of hepatitis A virus(HAV) antibodies in patients with chronic viral liver disease in Korea.We also tried to identify the factors affecting the prevalence of HAV antibodies. METHODS:We performed an analysis of the clinical records of 986 patients(mean age:49±9 years,714 males/272 females) with chronic hepatitis B virus(HBV) or hepatitis C virus(HCV) infection who had undergone HAV antibody testing between January 2008 and December 2009.RESULTS:The overall prevalence of IgG anti-HAV was 86.61%(854/986) in patients with chronic liver disease and was 88.13%(869/986) in age-and gendermatched patients from the Center for Health Promotion.The anti-HAV prevalence was 80.04%(405/506) in patients with chronic hepatitis B,86.96%(20/23) in patients with chronic hepatitis C,93.78%(422/450) in patients with HBV related liver cirrhosis,and 100%(7/7) in patients with HCV related liver cirrhosis.The anti-HAV prevalence according to the decade of age was as follows:20s(6.67%) ,30s(50.86%) ,40s(92.29%) ,50s(97.77%) ,and 60s(100%) .The antiHAV prevalence was significantly higher in patients older than 40 years compared with that in patients younger than 40 years of age.Multivariable analysis showed that age≥40 years,female gender and metropolitan cities as the place of residence were independent risk factors for IgG anti-HAV seropositivity. CONCLUSION:Most Korean patients with chronic liver disease and who are above 40 years of age have already been exposed to hepatitis A virus.