乙肝病毒前C基因变异对宿主T细胞亚群的影响及其临床意义的研究

目的　通过检测乙型肝炎病毒 (HepatitisBVirus,HBV)变异株感染患者外周血T细胞亚群分布的变化 ,探讨HBV基因组前C区 1896位基因变异与宿主机体免疫水平的关系 .方法　用酶联免疫吸附试验 (ELISA)检测 5 5名患者血清乙型肝炎病毒标志物 (HBVM)HBsAg ,抗 HBs,HBeAg ,抗HBe及抗 HBc;采用定性PCR法检测上述患者血清HBVDNA ;通过限制性片段长度多态性分析法 (RFLP)检测发生前C区 1896位基因突变的HBV变异株 ;采用流式细胞术 (flowcytometry)对上述患者外周血的CD4 + T细胞 ,CD8+ T细胞 ,CD3+ T细胞含量进行检测 ,将检测结果同所设健康对照组进行比较 ,并对数据进行统计学分析 .结果　在 5 5名患者中 ,HBsAg(+) ,anti HBs(- ) ,HBeAg(+) ,anti HBe(- ) ,anti HBc(+)者共 2 2例 ,其HBVDNA检测结果均为阳性 ,在这2 2例患者中 ,有 2 0例被检出为单纯HBV野毒株感染 ,另有 2例被检出为变异株和野毒株混合感染 ;HBsAg(+) ,anti HBs(- ) ,HBeAg(- ) ,anti HBe(+) ,anti HBc(+)者共 33例 ,其中HBVDNA阳性者为 18例 .在 18例HBeAg(- )而HBVDNA (+)的患者中 ,有 17例被检出为HBV前C区 1896位变异株感染 .变异株感染患者外周血CD4 + T细胞含量较之健康对照组有所减低 (P <0 .0 1) ,CD8+ T细胞含量较之健康对照组也有所

Effect of the HBV Pre-core Site Mutation on T sub-populations of Host Immunity and Its Clinical Significance

ObjectiveWT? To study the relationship between the HBV pre core 1896 site mutation and the host immunity through detecting the percentage of the peripheral blood T sub populations of the patients who were infected by the mutate type HBV.WT5HZ]Methods HBVM was detected by enzyme linked immunosorbent assay (ELISA); Polymerase chain reaction (PCR) assay was used to confirm HBV DNA; HBV pre core 1?896 site mutation was confirmed by restriction fragment length polymorphism (RFLP)analysis; the percentage of the CD4 +, CD8 +, CD3 + in peripheral blood of the patients were measured by flow cytometry, and the obtained data were compared with the data of the control group.Results HBsAg(+), anti HBs(-), HBeAg(+), anti HBe(-), anti HBc(+)were detected in 22 out of 55 patients, all those 22 patients were proved to have positive results in the HBV DNA test and 20 of them were proved to have infected by non mutate HBV. HBsAg(+), anti HBs(-), HBeAg(-), anti HBe(+), anti HBc(+) were detected in 33 out of 55 patients, and 18 out of those 33 patients were proved to have positive results in the HBV DNA test. HBV pre core 1?896 site mutation was confirmed in 17 of 18 HBeAg(-) and HBV DNA(+) cases. The percentage of CD4 +?CD8 + in peripheral blood of the patients in mutate group was lower than that of control group. The percentage of CD4+ of the patients in wild strain group that was in the cases of HBeAg(-) and HBV DNA(-) was higher than control group. The percentage of CD4 + was lower and the percentage of CD8 + was higher than that of control group in the cases with HBeAg(-) and HBV DNA(-).Conclusion The HBV pre core 1?896 site mutation can break the process of the synthesis of HBeAg, so that the host immune system could not be provoked by the HBeAg routinely. CD4 + lost the capability of identifying the HBV A lower level T lymphocyte immune reaction make the mutate virus escape from efficient destroy and severe liver damage could occur in such situation.