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Clinical relationships between cccDNA in sera with HBVDNA, YMDD mutants and hepatitis B relapse
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摘要: 目的探讨cccDNA与病毒复制及拉米夫定耐药突变（YMDD）及肝脏病变的关系。方法采用分子信标PCR技术检测HBV携带者（ASC）、慢性乙型肝炎（CHB）、乙型肝炎肝硬化（LC）、肝癌（HCC）患者血清中cccD-NA与HBVDNA及YMDD突变。结果在283例HBV感染者血清中,cccDNA阳性123例（43.46%）,均为HBVD-NA阳性标本;cccDNA与血清HBVDNA相关（x2=28.27,P<0.01）及ALT相关（x2=48.46,P<0.01）。60例接受拉米夫定治疗半年患者复查血清ALT、HBVDNA、YMDD及ccDNA,显示ALT异常32例（与cccDNA相关x2=48.46,P<0.01）,HBVDNA阳性24例（与cccDNA相关x2=28.27,P<0.01）,其中包括YMDD阳性18例与cccD-NA阳性16例（P=0.046）。结论血清cccDNA,是反映HBV复制及肝脏细胞损伤的血清标志。监测YMDD与血清cccDNA可以提示抗病毒治疗中HBV复制状态及病变进展情况。Abstract: Objective To investigate clinical relationship between cccDNA, Hepatitis B replication, YMDD mutants in sera and the hepatocyte injury of the liver.Methods PCR-molecular-beacon technique was used to examed cccDNA, HBV DNA and YMDD motif mutation in sera of subjects with HBV asymptomatic carriers (ASC) , chronic hepatitis (CHB) , liver cirrhosis (LC) and hepatocellular carcinoma (HCC) .Results 123 cccDNA positive samples were tested form all of 283 subjects sera (43.46%) , cccDNA was correlated with HBVDNA (x2=28.27, P<0.01) and with alanine aminotransferase (x2=48.46, P<0.01) .60 were examed ALT, HBVDNA, YMDD and cccDNA after treated with Lamivudine orally half a year, ALT were 32 abnormolity, HBVDNA were occurred in 24 subjects, including YMDD mutations occurred 18 and cccDNA 16 (correlated with cccDNA x2=48.46, P<0.01, x2=28.27, P<0.01 and P=0.046 repectivley) .Conclusion The occurrence of cccDNA in sera, may indicate HBV replication and liver damage.YMDD and cccDNA may be factors upon which the HBV replication status, the hepatic inflammation severity in anti-viral treatment.
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