Hepatitis D Virus Infection in Patients with Chronic Hepatitis B Virus Infection

慢性B型肝炎病毒感染病患之D型肝炎病毒感染

莊萬龍(Wan-Long Chuang) ； 張文宇(Wen-Yu Chang) ； 盧勝男(Sheng-Nan Lu) ； 林子堯(Zu-Yau Lin) ； 陳信成(Shinn-Cherng Chen) ； 謝明裕(Ming-Yuh Hsieh) ； 王良彥(Lian-Yen Wang) ； 吳重慶(Chung-Chieng Wu) ； 張瑞烽(Shui-Feng Chang) ； 周德源(Teh-Yuan Chow)

《The Kaohsiung Journal of Medical Sciences》 3卷2期 (1987/02) Pp. 121-127

https://doi.org/10.6452/KJMS.198702.0121

摘要

D型肝炎病毒爲一稱缺陷之核醣核酸病毒，需B型肝炎病毒之幫忙才能複製及傳染。台灣爲B型肝炎病毒感染之盛行地區，爲評估D型肝炎病毒感染在慢性B型肝炎感染病患之盛行率及對其病程之影響，作此研究分析。
從1985年8月至1986年12月，高雄醫學院肝膽穿刺檢查證實爲慢性B型肝炎者64例，肝硬化者10例，經病理或細胞學診斷爲肝細胞癌者37例接受血清抗D抗體、B型肝炎表面抗原、表面抗體、e抗原及e抗體等檢查。其中有65例也做了B型肝炎去氧核醣核酸檢查。肝炎標幟爲利用放射免疫分析檢查，B型肝炎去氧核醣核酸則以分子配對法偵測。
這些病人中合併D型肝炎感染者佔7.2%(8/111)，男爲7.1%(7/91)，女爲7.8(1/13)。感染率在各年齡層無顯著差異。e抗原陽性、e抗體陽性及兩者均陰性者之感染率分別爲5.3%(3/56)，8.3%(4/44)及14%(1/7)。B型肝炎去氧核醣核酸陽性者有8.1%(3/37)合併D型肝炎感染，去氧核醣核酸陰性者爲7.1%(2/28)合併D型肝炎感染。另外有26例B型肝炎表面抗原陰性之慢性肝臟疾患也接受抗D抗體檢查，結果均爲陰性。抗D抗體在各種慢性B型肝炎病毒感染之肝臟疾病之陽性率分別爲：慢性肝炎6.25%(4/64)，肝硬化30%(3/10)，肝細胞癌2.7%(1/37)。肝硬化病人有較高之陽性率，但p值均大於0.05。血清GPT超過正常十倍者之抗D抗體陽性率較介於5倍至十倍之間者爲低（p值等於0.034）。合併D型肝炎感染之病人中有四例(50%) e抗原陽性，三例(60%) B型肝炎去氧核醣核酸陽性，三例(37.5%)合併肝硬化，而所有病人血清GPT均小於正常值之十倍。
由上述資料，我們得以下結論：(1)男女性對於D型肝炎之感受性相同；(2)D型肝炎病毒感染似不影響B型肝炎病毒感染之狀況；(3)各年齡層成人之D型肝炎盛行率無顯著之差異；(4)D型肝炎感染可能會加重肝臟之破壞；(5)在台灣南部慢性B型肝炎感染病患之急性發作中D型肝炎感染並非重要之因素。

並列摘要

To assess the prevalence and influence of HDV infection in patients with chronic HBV infection, 111 pathologically proven chronic HBV infection patients, including 64 chronic hepatitis, 10 liver cirrhosis and 37 hepatocellular carcinoma cases were studied. The prevalence of HDV infection was 7.2% (8/111). The prevalence in male and female of occurrence subjects was 7.1% (7/91) and 7.8% (1/13) respectively. The difference of HDV infection among the different age groups was not significant. The prevalence in HBeAg positive, anti-HBe positive and both HBeAg and anti-HBe negative patients was 5.3% (3/56), 8.3% (4/44) and 14% (1/7), respectively. Three patients with HBV DNA were combined with HDV infection (8.1%, 3/37) and 7.1% (2/28) of HBV DNA negative patients were anti-D positive. None of the HBsAg negative patients was anti-D positive (0/26). Patients with liver cirrhosis had a higher HDV infection rate (30%, 3/10), but p values were over 0.05 when compared with chronic hepatitis and hepatoma groups. The prevalence of anti-D in patients with SGPT levels over 10 times was less than in patients with SGPT levels between 5 to 10 times (p=0.034). In patients with anti-D, four (50%) were HBeAg positive, three (60%, 3/5) were HBV DNA positive, three (37.5%) had liver cirrhosis and none was with SGPT level over 10 times of normal.
From these data, it could be concluded that: (1) male and female subjects were equally susceptible to HDV: (2) HDV infection did not influence the status of HBV infection; (3) the prevalence in different age groups of adults showed no significant differences; (4) HDV infection might increase liver damage; (5) HDV infection played a less important role in acute exacerbation of chronic HBV infection in southern Taiwan.

並列關鍵字

hepatitis D virus ； hepatitis B virus ； chronic HBV infection