HBV急性和慢性期患者HBsAg和抗hbs的共存。

IF 2.5 4区医学 Q3 VIROLOGY

Virus research Pub Date : 2025-03-31 DOI:10.1016/j.virusres.2025.199567

Zhongshu Pu , Zhaohua Ji , Haixia Su , Ting Fu , Zhongjun Shao , Yongping Yan

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引用次数: 0

摘要

乙型肝炎病毒（HBV）感染中HBsAg和抗hbs共存是一种不寻常的血清学模式。然而，其自然进程仍不清楚。本研究调查了这种血清学模式在急性期和慢性期HBV患者中的发生情况，并估计了相关的风险。在215例诊断为急性期HBV的成人患者中，19例（8.84%）表现出HBsAg和抗hbs共存。在慢性期，在4593例HBsAg阳性患者中，在14个月的中位随访期间（四分位数范围：14-28）发现了54例HBsAg和抗hbbs共存的新病例。年平均共存率为1.41%±0.28%。慢性期患者HBsAg和抗- hbs共存的累积风险在年龄≥50岁的患者中较高（风险比[RR]: 1.79, 95%可信区间[CI]: 1.04-3.09, P = 0.035），HBeAg阳性（RR: 3.43, 95% CI: 1.91-6.19, P < 0.001），基线丙氨酸转氨酶异常（RR: 3.62, 95% CI: 1.93-6.79, P < 0.001）， HBV DNA水平较高（RR: 1.97, 95% CI: 1.12-3.49, P = 0.017）。在HBV感染中与HBsAg和anti-HBs共存的过程中，“a”决定突变的准种异质性无明显变化。因此，HBsAg和anti-HBs共存可能是HBV感染自然史中的中间过程，与“一个”决定性突变无关，但与疾病阶段有关。

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HBsAg and anti-HBs coexistence in patients with HBV in acute and chronic phases

HBsAg and anti-HBs coexistence represents an unusual serological pattern in hepatitis B virus (HBV) infection. However, its natural course remains unclear. This study investigated the occurrence of this serological pattern in patients with HBV in acute and chronic phases and estimated the associated risks. Of the 215 adult patients diagnosed with acute-phase HBV, 19 (8.84 %) cases demonstrated HBsAg and anti-HBs coexistence. In the chronic phase, 54 new cases of HBsAg and anti-HBs coexistence were identified during a median follow-up of 14 months (interquartile range: 14–28) among 4593 HBsAg-positive patients. The average annual incidence of coexistence was 1.41 % ± 0.28 %. The cumulative risk of HBsAg and anti-HBs coexistence in chronic phase patients was higher in those aged ≥ 50 years (risk ratio [RR]: 1.79, 95 % confidence interval [CI]: 1.04–3.09, P = 0.035), with positive HBeAg (RR: 3.43, 95 % CI: 1.91–6.19, P < 0.001), baseline alanine transaminase abnormalities (RR: 3.62, 95 % CI: 1.93–6.79, P < 0.001), and higher HBV DNA levels (RR: 1.97, 95 % CI: 1.12–3.49, P = 0.017). The quasispecies heterogeneity of the “a” determinant mutation demonstrated no significant change during the occurrence of coexistence with HBsAg and anti-HBs in HBV infection. Therefore, HBsAg and anti-HBs coexistence may be the intermediate process in the natural history of HBV infection, unrelated to “a" determinant mutation but associated with the disease phase.

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来源期刊

Virus research 医学-病毒学

CiteScore

9.50

自引率

2.00%

发文量

239

审稿时长

43 days

期刊介绍： Virus Research provides a means of fast publication for original papers on fundamental research in virology. Contributions on new developments concerning virus structure, replication, pathogenesis and evolution are encouraged. These include reports describing virus morphology, the function and antigenic analysis of virus structural components, virus genome structure and expression, analysis on virus replication processes, virus evolution in connection with antiviral interventions, effects of viruses on their host cells, particularly on the immune system, and the pathogenesis of virus infections, including oncogene activation and transduction.