Epidemiological characteristics of the carriers with coexistence of HBsAg and anti-HBs based on a community cohort study
Epidemiological characteristics of the carriers with coexistence of HBsAg and anti-HBs based on a community cohort study
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基于社区队列研究的HBsAg与抗-HBs共存携带者流行病学特征
DOI：
10.1111/jvh.12492
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发表时间：
2016-04-01
影响因子：
2.5
通讯作者：
Yan, Y.
中科院分区：
文献类型：
--
作者：
Pu, Z.;Li, D.;Yan, Y.
乙肝表面抗原与抗-HBs共存是一种不典型的乙肝病毒感染的血清学模式。这种血清学模式在社区中没有流行病学特征，对这种模式背后的分子机制也存在争议。我们在纵向社区队列研究中调查了乙肝表面抗原携带者和抗-HBs携带者的流行病学特征。这种非典型血清学模式在HBs Ag阳性人群中的患病率为2.93%(122/4169)。从40岁到70岁，患病率随年龄增长而递增。HBeAg阳性和HBVdna阳性携带者均显著高于抗-HBs阴性携带者(26/122vs598/4047P=0.046；86/122vs275/529P<；0.001)。随访1年，85.19%的携带者仍有HBs Ag和抗-HBs共存，14.81%的携带者抗-HBs消失。病毒测序显示，HBs Ag和抗-HBs共存的携带者S基因的残基改变数高于HBs Ag阳性而抗-HBs阴性的携带者(2.42vs1.33/100个残基，P<；0.05)。因此，HBs Ag和抗-HBs共存是一种独特的血清学模式，可能与不良临床结局的风险增加有关，并可能与具有基因异质性的HBs Ag免疫变异有关。
The coexistence of HBsAg and anti-HBs is an atypical serological pattern in HBV infection. There is no epidemiological characteristics of this serological pattern in the community and there is controversy over the molecular mechanisms underlying this pattern. We investigated the epidemiological characteristics of the carriers with HBsAg and anti-HBs in a longitudinal community cohort study. The prevalence of this atypical serological pattern was 2.93% (122/4169) in HBsAg-positive populations. The prevalence progressively increased with age from 40 to 70 years old. The rate of HBeAg positive and detectable HBV DNA were both significantly higher in carriers with this pattern than in carriers who were HBsAg positive but anti-HBs negative (26/122 verse 598/4047, P = 0.046; 86/122 verse 275/529,P < 0.001). After 1 year of follow-up, 85.19% of the carriers still had coexistence HBsAg and anti-HBs, 14.81% of the carriers lost their anti-HBs. Viral sequencing showed that carriers with coexistence of HBsAg and anti-HBs had higher numbers of residue changes within the S gene than carriers who were HBsAg positive but anti-HBs negative (2.42 verse 1.33 changes per 100 residues, P < 0.05). Hence, the coexistence of HBsAg and anti-HBs is a unique serological pattern which may be associated with an increased risk of adverse clinical outcome and may be related to HBsAg immune variants which have genotypic heterogeneity.