乙型肝炎高发地区慢性无症状感染者的临床病理学特点

在一个HBV高感染人群中肝活检289例,包括慢性无症状肝炎39例,无任何临床表现的慢性无症状携带者(ASC)218例,短暂无症状携带者10例和携带状态结束者22例。在ASC中CAH(有或无肝硬化)7.3%、CPH22.0%、CLH10.6%、轻微病变48.2%、肝组织正常者11.9%。无症状肝炎的病变相对较重,短暂携带者病变轻微,携带状态结束者尚有少数慢性肝炎。在257例慢性HBV感染者中,有无症状CAH26例(10.1%)、无症状CPH61例(23.7%),强调它们在HBV感染结构中的重要地位。肝轻微病变占ASC的半数,可能是相当稳定的一种对HBV持续感染的低反应状态。上述结果可能构成高发地区HBV感染的特点:无症状感染众多,肝组织病变率高以及低反应感染状态常见。

Clinico -pathological features of chronic asymptomatic hepatitis B virus infection in high prevalance area

From a population with high hepatitis B virus ( HBV ) prevalance, 289 liver biopsies were performed, including 39 cases of chronic asymptomatic hepatitis(ASH), 218 chronic asymptomatic carriers ( ASC ) , 10 transient carriers and 22 cases after carrier status ended. Among ASC, there were chronic active hepatitis ( CAH, with or without cirrhosis ) 7 . 3%, chronic persistent hepatitis ( CPH ) 22 .0% , chronic lo~ bular hepatitis ( CLH) 10 .6%, minimal changes 48.2% and normal histology 11.9%. The pathological changes of ASH were more severe, those of transient carriers milder and some cases after carrier status ended still and chronic hepatitis remained. Among 257 cases with chronic HBV infection there were 21 ( 10.1% ) cases of asymptomatic CAH and 61 (23.7% ) of asymptomaic CPH. Their importance in the composition of HBV infections was emphasized. Near half of ASC were cases of minimal changes, which might be a considerably steady status of hypo-reactivity to prolonged HBV infection. From the above results, the clinico-pathological features of HBV infection in high prevalance area might be: numerous asymptomatic infections high rate of pathological changes and frequent hypo-reactivity of infection in them.