低水平HBsAg慢性无症状HBV携带者临床特征及S基因序列分析。

StephenW

Clin Res Hepatol Gastroenterol. 2018 Oct 4. pii: S2210-7401(18)30179-7. doi: 10.1016/j.clinre.2018.08.015. [Epub ahead of print]
Analysis of clinical characteristics and S gene sequences in chronic asymptomatic HBV carriers with low-level HBsAg.
Wang T1, Cui D2, Chen S3, Xu X4, Sun C5, Dai Y6, Cheng J7.
Author information

1
    Faculty of Graduate Studies, Bengbu Medical College, Bengbu 233000, PR China; Department of Clinical Research, The 117th Hospital of PLA, Hangzhou 310013, PR China; Faculty of Graduate Studies, Jiangsu University, Zhenjiang 212013, PR China. Electronic address: [email protected].
2
    Department of Laboratory Medicine, Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, PR China; Faculty of Graduate Studies, Jiangsu University, Zhenjiang 212013, PR China. Electronic address: [email protected].
3
    Department of Clinical Research, The 117th Hospital of PLA, Hangzhou 310013, PR China; Faculty of Graduate Studies, Jiangsu University, Zhenjiang 212013, PR China. Electronic address: [email protected].
4
    Department of Biotechnology, The University of Tokyo, Tokyo 1138656, Japan; Faculty of Graduate Studies, Jiangsu University, Zhenjiang 212013, PR China. Electronic address: [email protected].
5
    Department of Clinical Research, The 117th Hospital of PLA, Hangzhou 310013, PR China; Faculty of Graduate Studies, Jiangsu University, Zhenjiang 212013, PR China. Electronic address: [email protected].
6
    Department of Clinical Research, The 117th Hospital of PLA, Hangzhou 310013, PR China; Department of Laboratory Medicine, Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, PR China. Electronic address: [email protected].
7
    Department of Clinical Research, The 117th Hospital of PLA, Hangzhou 310013, PR China; Faculty of Graduate Studies, Jiangsu University, Zhenjiang 212013, PR China. Electronic address: [email protected].

Abstract
BACKGROUND:

During the natural hepatitis B virus (HBV) infection process, some infected subjects are characterized by a sustained low serum HBV surface antigen (HBsAg) expression level. Most members in this population are chronic asymptomatic HBV carriers (ASCs). To elucidate the mechanism underlying low-level HBsAg expression in ASCs, we sequenced the HBV S gene in these patients to reveal specific sequence characteristics.
METHODS:

Overall, 1308 cases of chronic ASCs were grouped according to their HBsAg serum expression levels (10 IU/mL). The clinical characteristics of the population were analysed in detail. The HBV S gene was sequenced from 276 ASC cases with low-level HBsAg expression. Additionally, 100 of 1032 ASC cases with high-level HBsAg expression were randomly selected for HBV S gene sequencing based on age matching according to the low-level HBsAg group. A comparative analysis was conducted with the HBV S gene sequences from ASCs with low HBsAg expression and the HBV reference S gene sequences from ASCs with high HBsAg expression.
RESULTS:

The population with low-level HBsAg expression displayed the following primary clinical characteristics: mostly chronic asymptomatic HBV carriers, older age (mean age 55.09 years), HBsAg/anti-HBe/anti-HBc (core) positivity as the main serological pattern (97.1%), low HBV DNA replication (1.32 ± 1.60 log10 IU/mL), a low HBV-DNA positive rate (45.65%) and primarily genotype B (82.54%) and serotype adw (84.13%). The comparative analysis of the HBV S gene sequences from ASCs with low-level HBsAg showed significant mutations (including co-mutations) on both sides of the main hydrophilic region (MHR).
CONCLUSION:

Significant mutations in multiple regions and at multiple sites (including co-mutations) on both sides of the MHR may be one cause of the low HBsAg expression level in this population.

Copyright © 2018 Elsevier Masson SAS. All rights reserved.
KEYWORDS:

HBV DNA; HBV S gene; HBV genotype; HBV markers; HBsAg; Mutation site

PMID:
    30293895
DOI:
    10.1016/j.clinre.2018.08.015

StephenW

Clin Res Hepatol Gastroenterol。 2018年10月4日.pii：S2210-7401（18）30179-7。 doi：10.1016 / j.clinre.2018.08.015。 [提前打印]
低水平HBsAg慢性无症状HBV携带者临床特征及S基因序列分析。
王T1，崔D2，陈S3，徐X4，孙C5，戴Y6，程J7。
作者信息

1
    蚌埠医学院研究生院，蚌埠233000;解放军第117医院临床研究室，杭州310013;江苏大学研究生院，镇江212013电子地址：[email protected]。
2
    浙江大学医学院第一附属医院浙江省临床体外诊断技术重点实验室，杭州310003;江苏大学研究生院，镇江212013电子地址：[email protected]。
3
    解放军第117医院临床研究室，杭州310013;江苏大学研究生院，镇江212013电子地址：[email protected]。
4
    东京大学生物技术系，东京1138656;江苏大学研究生院，镇江212013电子地址：[email protected]。
五
    解放军第117医院临床研究室，杭州310013;江苏大学研究生院，镇江212013电子地址：[email protected]。
6
    解放军第117医院临床研究室，杭州310013;浙江大学医学院附属第一医院检验医学科，浙江省临床体外诊断技术重点实验室，杭州310003电子地址：[email protected]。
7
    解放军第117医院临床研究室，杭州310013;江苏大学研究生院，镇江212013电子地址：[email protected]。

抽象
背景：

在天然乙型肝炎病毒（HBV）感染过程中，一些感染的受试者的特征在于持续的低血清HBV表面抗原（HBsAg）表达水平。该人群中的大多数成员是慢性无症状HBV携带者（ASCs）。为了阐明ASC中低水平HBsAg表达的机制，我们对这些患者中的HBV S基因进行了测序，以揭示特定的序列特征。
方法：

总体而言，1308例慢性ASC根据其HBsAg血清表达水平（10 IU / mL）进行分组。详细分析了人群的临床特征。从具有低水平HBsAg表达的276个ASC病例中对HBV S基因进行测序。此外，根据低水平HBsAg组，基于年龄匹配，随机选择100个具有高水平HBsAg表达的1032个ASC病例进行HBV S基因测序。对来自具有低HBsAg表达的ASCs的HBV S基因序列和来自具有高HBsAg表达的ASC的HBV参考S基因序列进行比较分析。
结果：

低层次的HBsAg表达人口显示以下主要临床特征：大多慢性无症状HBV携带者，年龄（平均年龄55.09年）的HBsAg /抗-HBe /抗HBc（芯）阳性为主要的血清学图样（97.1 ％），低HBV DNA复制（1.32±1.60 log10 IU / mL），低HBV-DNA阳性率（45.65％）和主要基因型B（82.54％）和血清型adw（84.13％）。来自具有低水平HBsAg的ASC的HBV S基因序列的比较分析显示主要亲水区（MHR）两侧的显着突变（包括共突变）。
结论：

MHR两侧多个区域和多个位点（包括共突变）的显着突变可能是该群体中HBsAg低表达水平的一个原因。

版权所有©2018 Elsevier Masson SAS。版权所有。
关键词：

HBV DNA; HBV S基因; HBV基因型; HBV标志物;乙肝表面抗原;变异网站

结论：
    30293895
DOI：
    10.1016 / j.clinre.2018.08.015

a44573060

然后呢，这代表着什么呢

StephenW

回复 a44573060 的帖子

这项研究建议，由于MHR区突变可能导致HBsAg产量降低.

春景

未经抗病毒治疗，表面抗原突然大幅度降低，这种情况可能需要谨慎，有可能是突变的危险？

sky8989

回复 春景 的帖子

要考虑不好的结果