HBsAg may reappear following reactivation in individuals with spontaneous HBsAg seroclearance 8 years previously
HBsAg may reappear following reactivation in individuals with spontaneous HBsAg seroclearance 8 years previously
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DOI：
10.1017/s095026881600279x
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发表时间：
2017-03-01
影响因子：
4.2
通讯作者：
Fang, Z. L.
中科院分区：
文献类型：
--
作者：
Chen, Q. Y.;Wang, X. Y.;Fang, Z. L.
HBsAg的再次出现不仅是肝病的危险因素，也是一种传染源。我们的目的是确定HBsAg是否可能在自发HBsAg血清清除后重新出现。2004年在中国广西招募了2999名年龄在30-55岁之间的HBsAg阳性受试者。从2004年7月到2007年6月，每6个月检测一次HBsAg，然后在2013年12月再检测一次。结果表明，在最初的3年中，41名受试者发生了自发的HBsAg血清清除，年血清清除率为0 - 54%。2013年，41例受试者中有13例接受了HBsAg随机检测。4例受试者变为HBsAg阳性。分别分析了受试者QS 840（11和12个克隆）、受试者TN 98（13和13个克隆）和受试者WX 227（10和8个克隆）血清清除前和重现后采集的血清中HBV S基因序列。对HBsAg清除前采集的样本进行血清型、亚型和氨基酸替换模式的观察。来自每个受试者的两个序列之间的核苷酸相似性>99%，并且来自受试者TN 98的五个序列相同。总之，在再活化后，HBsAg可能在多年前自发HBsAg血清清除的个体中重新出现。
HBsAg reappearance may constitute not only a risk for liver disease but also an infectious source. We aimed to determine whether HBsAg may reappear after spontaneous HBsAg seroclearance. A cohort of 2999 HBsAg- positive subjects aged 30-55 years was recruited in Guangxi, China in 2004. HBsAg was tested every 6 months from July 2004 to June 2007, then, one more time in December 2013. The results showed that spontaneous HBsAg seroclearance occurred in 41 subjects in the first 3 years, giving a 0 - 54% annual seroclearance rate. Thirteen of the 41 subjects were randomly tested for HBsAg in 2013. Four subjects became HBsAg positive. S gene sequences of HBV were analysed from serum collected before seroclearance and after reappearance, respectively, for subject QS840 (11 and 12 clones), subject TN98 (13 and 13 clones) and subject WX227 (10 and 8 clones). Serotype, subgenotype and amino-acid substitution pattern in each sample collected after reappearance was observed in the sample collected before HBsAg seroclearance. Nucleotide similarity between the two sequences from each subject was >99% and five sequences from subject TN98 were the same. In conclusion, following reactivation, HBsAg may reappear in individuals with spontaneous HBsAg seroclearance many years previously.