慢性乙型肝炎病毒无症状感染者的传染状态与肝组织病变

本文对265例慢性HBV无症状感染者进行了临床—病理—病毒学研究,结果表明:肝内HBV DNA存在游离型、游离—整合型和整合型三种分子状态,或肝内HBV感染发展的三个时相。表达于血液的HBV感染过程为:处于传染时相的病毒携带,非传染时相的抗原携带,以及病毒清除后仅残留于肝内的基因组携带。游离型HBV DNA是病毒的复制状态,表达为HBeAg、HBcAg和血清HBV DNA;血清HBsAg水平与之呈平行关系,但难以划分传染与非传染时相的界限值;抗HBe亦不是否定血液传染时相的标志。表明病毒感染状态的大多数参数,在不同肝组织病变间无明显差别,可能由于慢性无症状感染者的低免疫应答性以及病变可能主要是对长期感染的组织反应积累的结果。

Chronic asymptomatic hepatitis B virus (HBV) infection: infectious status and liver histopathology

The investigations on clinico-patho-virology were carried out in 265 cases with chronic asymptomatic HBV infection and the results showed there were 3 molecular status of virus DNA, or 3 successive phases of HBV infection, in the liver: free,free-integrated and integrated types. The course of HBV infection in blood went through 3 stages: virus carriage (infectious phase) , antigen carriage and onlg genome carriage remnant in liver (non-infectious phase) after clearence of both the virus and antigens. Free nucleic acid,which is the replicative form of virus, can express HBeAg, HBc-Ag and HBV DNA in serum. Serum HBsAg level was directly correlated with these serological markers, but it is difficult to give a cut off between infectious and non-infectious phases.Anti-HBe was not a counter-evidence of the infectious phase either. Most of the parameters which reflect status of HBV infection had no significant differences among the different inflammatory (or immune) activities of the liver in the histopathology, this might be due to the hypoimmunoreactivities of these cases and because the liver affections might mainly be resulted from the accummuclation of lesions during a long-term infection.