【摘要】 目的　了解我国人群乙型肝炎病毒 (HBV)和丙型肝炎病毒 (HCV)合并感染后的自然过程。方法　对 87例HBV和 /或HCV的慢性感染者分别于 1994年与 2 0 0 2年进行了两次追踪 ,其中HBV/HCV合并感染组 4 0例 ,HBV单独感染组 16例 ,HCV单独感染组 31例。用ELISA法检测病毒的血清学指标 ,荧光定量PCR法进行HBVDNA及HCVRNA的定量 ,并进行生化指标的检测以及B超检查。结果　在感染病毒 14年～ 2 1年后 ,HBV/HCV合并感染者中合并感染组血清HBsAg、HBeAg和HBVDNA的自发清除率分别为 6 7 5 %、92 5 %和 87 5 % ,与HBV感染组相比差异无显著性。合并感染组中HCVRNA的清除率为 87 5 % ,高于HCV感染组。各组中生化或B超检查异常者不足 4 0 % ,且基本为轻到中度异常。结论　合并感染者的临床表现较隐匿 ,较高的HBV的清除率 ,男性更容易清除HBsAg ,HBVDNA载量的高低不影响病毒的清除是我国成年感染HBV后的特点。HBV可以抑制HCV的复制 ,没有足够的证据表明HCV可以抑制HBV的复制。更多还原

【Abstract】 Objecive To investigate the clinical and virological course of dual infection by hepatitis B virus (HBV) and hepatitis C virus (HCV) in China Methods We enrolled 40 patients with chronic HBV and HCV dual infection (Group BC), 16 patients with chronic single HBV infection (Group B) and 31 patients with chronic single HCV infection (Group C) They infected HBV and/or HCV during 1982 to 1989 The sera of all the 87 patients were collected in 1994 and 2002 respectively We detected biochemical and virologic markers and quantitative serum HCV DNA and HCV RNA levels of all the patients The B-type ultrasound detecting was performed in some patients Results In Group BC, 675% of the patients have cleared HBsAg, and 925% of the patients have cleared HBeAg The clearance rate of HBV DNA was 875% There was no significant difference of HBV clearance between Group BC and Group B In Group BC, the clearance rate of HCV-RNA was 875%, significantly higher than that in Group C Less than 40% of the patients in all groups have elevated liver enzyme values The highest value of alanine aminotransferase (ALT) was 218 U/L (normal range for ALT 0-40u/L) In most patients the ultrasonogram presentations were changed mildly Conclusion The clinical presentation of patients with HBV/HCV coinfection seemed mild and occult High clearance of HBV, easy to clear HBV in male patients were the characteristics of infection by HBV in adult time in China HBV could inhibit HCV replication, but no evidence could be found in our data that HCV could suppress HBV replication更多还原