【摘要】 目的了解乙型肝炎血清免疫学标志物(HBV M)阴性而有病毒复制者的产生原因。方法65例肝活检患者中16例血清HBVM(包括HBsAg、抗HBs、HBeAg、抗HBe及抗HBc)2次以上检测全部阴性。6例血清ALT水平多次检测正常,结合病史诊断为HBV携带者;8例诊断为慢性乙型肝炎;2例为肝硬化。结果6例HBV携带者中4例病毒负荷104~105copies/ml,炎症及纤维化程度为G1、S18例慢性肝炎中4例血清病毒>105~106copies/ml,2例肝硬化者低于104copies/ml。免疫组化肝组织所见有HBsAg或/和HBcAg表达。结论隐匿性HBV感染的发生可能有多种机制参与。更多还原

【Abstract】 Objective To investigate the possible cause of hepatitis B vireus(HBV) replicative infection in the patients with negative hepatitis B serological markers(HBVM).Methods Liver biopsy was done in 65 cases.Of whom,16 cases had negative hepatitis B serological markers including HBsAg, anti-HBs,HBeAg,anti-HBe,anti-HBc and anti-HCV.ALT level of 6 cases (out of 16) was normal by repeated examination and they were suspected to be HBV carriers either by the evidence of clinical status or by having family history of hepatitis B.Eight patients were initialy diagnosed as chronic hepatitis,and 2 cases as liver cirrhosis.Results Of 6 HBV carriers,4 cases initiallly diagnosed as HBV carriers and all showed high viral replication with the load of 10~4～10~5 copies/ml and the periportal and/or intralobular inflammation degree of G1 and S1.Of 8 cases with chronic hepatitis,4 patients had a high load of >10~5～10~6 copies/ml,and 2 cases had a load of<10~4 copies/ml.Conclusion Multiple mechanisms are involved in the occult asymptomatic infection of HBV.更多还原