J Med Virol：在HBeAg/anti-HBe血清学转换过程中，HBV基因D型儿童HBV Pre-Core的选择性突变，导致成年后HBeAg阴性慢性乙型

2018-03-10 MedSci MedSci原创

选择性的Pre-C突变发生在HBV复制控制不良的儿童的HBeAg/anti-HBe血清学转换时期，导致成年后HBeAg-阴性慢性-活动性肝炎

研究背景：在儿童时期HBeAg缺陷HBV突变体的选择性可能会影响成人的感染结果。本研究的目的是研究选择性的Pre-Core HBV突变(Pre-C mt)与儿童随访至成年期的病毒学/临床结果的相关性。

研究方法：在80例研究者中，男性50例，女性30例，70例患者血清学结果为HBeAg 阳性，10例患者血清学结果为HBeAg-阴性/anti-HBe阳性，大部分儿童患者(91.2%)为HBV 基因D型，平均年龄为6.5岁(范围：0.2-17岁)，研究随访14.3年(范围：1.1-24.5年)，46例儿童患者(57.5%)接受干扰素治疗。HBV DNA和q-HBsAg水平通过商业化试剂盒检测。通过直接测序、寡核苷酸杂交检测和等位基因-特异性-PCR法检测Pre-Core 1896突变。

研究结果：70例HBeAg阴性儿童患者中，55例儿童患者发生HBeAg/anti-HBe血清学转换(SC)。发生血清学转换后，8例儿童患者发展为HBeAg（-）的慢性乙型肝炎；41例儿童患者仍为HBeAg（-）慢性携带者；6例患者HBsAg转阴。相比未发生HBeAg/anti-HBe血清学转换的患者，发生HBeAg/anti-HBe血清学转换的患者血清HBV DNA和HBsAg 水平均显著降低(平均： 7.35 vs 8.95 Log IU/mL， P = 0.005 and 4.72 vs 5.04 Log IU/ml， P = 0.015)。在发生血清学转换时期，Pre-C突变快速增加(10%到40%)。最终，在CHB患者中全部检测到Pre-C突变；33%的慢性携带者中发现Pre-C突变；16%的HBsAg阴性的患者出现Pre-C突变。相比那些具有优势Pre-C 突变的患者，具有优势/混合Pre-C突变的HBeAg阴性携带者，HBV DNA水平仍然略高。

研究结论：选择性的Pre-C突变发生在HBV复制控制不良的儿童的HBeAg/anti-HBe血清学转换时期，导致成年后HBeAg-阴性慢性-活动性肝炎。

原始出处

Colombatto P， Barbera C， Bortolotti F， et al. HBV Pre-Core mutant in genotype-D infected children is selected during HBeAg/anti-HBe seroconversion and leads to HBeAg negative chronic hepatitis B in adulthood. J Med Virol， 2018， Feb 28. doi： 10.1002/jmv.25068.

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2018-04-20 klivis

#HBV#

28 0
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2018-06-11 肉我只吃一口

#选择性#

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2018-09-11 ms3892185887221420

#Virol#

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2018-03-12 xiaoshitou

#HBeAg#

43 0
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2018-03-12 jjjiang0201

#血清学#

37 0
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2018-03-12 docwu2019

#CORE#

26 0
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2018-03-12 爆笑小医

#Med#

22 0
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2018-03-10 神功盖世

阅

78 0
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2018-03-10 1e17414fm02(暂无匿称)

学习

68 0

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