慢性乙型肝炎病毒合并感染的流行及临床意义

D. V. Tserashkou, V. Mitsura, E. Voropaev, O. Osipkina
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引用次数: 0

摘要

背景。乙型肝炎病毒(HBV)感染仍然是一个全球公共卫生问题。目的:分析慢性乙型肝炎(CHB)患者与人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)、丁型肝炎病毒(HDV)、tt病毒和SENV病毒共感染的流行情况,并评估它们对肝脏疾病严重程度的影响。材料和方法。这项观察性横断面研究包括287例慢性乙型肝炎病毒(HBV)患者,包括单感染和合并感染HIV、HCV、HDV的患者。进行常规血液学、生化检查,测定血清HBV DNA水平及肝纤维化分期。采用聚合酶链反应法检测62例患者血液中转矩丁诺病毒(TTV)、转矩丁诺迷你病毒(Torque teno mini virus)、转矩丁诺midi病毒(Torque teno midi virus)、转矩丁诺病毒(SENV) (D和H基因型)dna。结果。在慢性乙型肝炎患者中,HBV + HIV合并感染的患病率为6.6%,HBV + HCV - 6.3%, HBV + HDV - 3.8%, HBV + HDV + HCV - 1.7%。合并HIV、HCV、HDV感染的CHB患者与单hbv感染的CHB患者生化差异更明显,肝硬化比例更高。TT病毒及其各种组合在CHB患者中的检出率为91.9%,SENV - 66.1%。结论。慢性乙型肝炎患者同时感染HIV、HCV、HDV与更严重形式的慢性肝病相关。TT病毒和SENV广泛存在,并不影响慢性乙型肝炎患者肝脏疾病的严重程度。
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VIRAL COINFECTIONS IN PATIENTS WITH CHRONIC HEPATITIS B: THEIR PREVALENCE AND CLINICAL SIGNIFICANCE
Background. Hepatitis B virus (HBV) infection remains a global public health problem. Objective – to analyze the prevalence of viral coinfections with human immunodefciency virus (HIV), hepatitis C virus (HCV), hepatitis delta virus (HDV), TT-viruses and SENV in patients with chronic hepatitis B (CHB) and to assess their influence on liver disease severity. Material and methods. The observational cross-sectional study included 287 patients with chronic hepatitis B virus (HBV) – those with monoinfection and coinfected with HIV, HCV, HDV. Routine hematological and biochemical tests were performed, serum HBV DNA level as well as liver fbrosis stage were measured. Blood samples from 62 patients for Torque teno virus (TTV), Torque teno mini virus, Torque teno midi virus, SENV (D and H genotypes) DNAs were examined by polymerase chain reaction. Results. Among patients with CHB the prevalence of coinfection HBV + HIV is 6.6%, HBV + HCV – 6.3%, HBV + HDV – 3.8% and HBV + HDV + HCV – 1.7%. CHB patients coinfected with HIV, HCV, HDV had more pronounced biochemical differences and higher proportion of liver cirrhosis vs. HBV-monoinfected ones. The detection rate of TT viruses and their various combinations in patients with CHB is 91.9%, SENV – 66.1%. Conclusion. Coinfection with HIV, HCV, HDV in CHB patients is associated with more severe forms of chronic liver disease as compared to HBV-monoinfection. TT viruses and SENV are widespread and don’t affect the severity of liver disease in patients with CHB.
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