慢性乙型肝炎病毒感染者家系隐匿性乙型肝炎病毒感染的调查分析-内科学(传染病)专业毕业论文.docxVIP

安徽医科大学硕士学位论文 安徽医科大学硕士学位论文 5 5 The Study of Occult Hepatitis B Infection in Family Members of Chronic Hepatitis B Infection Abstract Background Chronic carriers of hepatitis B virus (HBV) usually show hepatitis B surface antigen (HBsAg) in their sera, which is considered the marker for acute and chronic HBV infection. however,in some individuals, this antigen can not be detected by routine serological assays despite the presence of virus in liver and peripheral blood, that is, occult hepatitis B virus infection, is defined as HBsAg negative in their serum, HBV DNA positive in serum or liver tissue. This special form of infection may occur in anti-HBs or anti-HBc positive patients,but is also found in individual with all markers of hepatitis B negative. At present, there is not definitive conclusion on the incidence of occult hepatitis B virus infection in different populations, with respect to the incidence in family members of chronic HBV infection patients is also inconsistent.viral repliation and gene expression levels of this particular form of infection were usually very low, but rise to the reasions for this are mostly unclear.Various attempts have been made to clarify the mechanism(s) responsible for this serological pattern. Two possibilities are discussed: either the antigen is indeed absent from the peripheral blood or it is present but not detectable. The first alternative, absence of HBsAg, could be due to mutations that block the export of the antigen, as described for certain pre-S deletions. The second alternative, HBsAg is present but not detectable by standard enzyme immunoassay techniques, could be ascribed to the presence of circulating immune complexes between HBsAg and anti-HBs, which can worsen or even inhibit completely the detection of both the antigen and the antibody. Many studies suggest that low levels of virus replication is the reason for HBsAg negative in peripheral blood,however, others 6 6 consider that genen mutation,par