ANALYSIS OF HEPATITIS B VIREMIA AMONG HBS ANTIGEN-NEGATIVE PEOPLE (MUTUAL REACTION BETWEEN HBV AND CYTOTOXIC T CELLS)

人们一直认为，乙型肝炎病毒在急性乙型肝炎后会从免疫功能正常的成年人体内完全清除。然而，最近的研究表明，在急性自限性乙型肝炎后，低水平的病毒血症会持续很长时间。这表明，大量有急性自限性乙型肝炎感染史的人血液中HBV水平较低。我们研究了50名乙型肝炎抗原（HBsAg）阴性和乙型肝炎核心抗体（anti-HBc）阳性的献血者的血清HBV-DNA阳性。50名献血者中有19名（38%）检测到HBV-DNA。19名献血者中有8人携带非免疫球蛋白结合（非免疫复合物）形式的HBV-DNA。8名献血者中有5人的HBV-DNA也是免疫球蛋白结合（免疫复合物）形式。其余11例仅以免疫球蛋白结合（免疫复合物）形式存在HBV-DNA。HBV-DNA阳性供者的HBV-DNA水平与急性乙型肝炎缓解期相似。用DNase - 1消化血清没有改变HBV-DNA水平。对6例供体（3例adr亚型和3例adw亚型）的press - s区氨基酸序列进行分析。虽然每个供体有不同的序列，但没有发现共同的突变。在主要疏水区（MHR）未发现突变。这表明一些hbsag阴性和抗hbsag阳性的献血者血清中存在shbv感染。我们分析了这种“隐性”HBV对hcv相关和非b、非c型肝细胞癌（HCC）患者肝癌发生的影响。在hcv相关的HCC病例中效果较低。非b型、非c型HCC患者的影响应仔细分析，因为这些病例的基因组结构与献血者不同。

It has been thought that hepatitis B virus is completely cleared from body of immunocompetent adults after acute hepatitis B.However, recent studies have shown that low levels of viremia continue for long after acute, self-limited hepatitis B.These suggest that a substantial number of people with a previous history of acute, self-limited infection have low levels of HBV in their blood. We have studied the positivity of serum HBV-DNA among 50 blood donors who were negative for HBs antigen (HBsAg) and positive for hepatitis B core antibody (anti-HBc). HBV-DNA was detected in 19 of 50 (38%) of donors. In 8 of the 19 donors have HBV-DNA in the non-immunoglobulin-bound (non-immune-complex) form. Five of the eight donors have HBV-DNA also as immunoglobulin-bound (immune-complex) form. The remaining 11 have HBV-DNA in the immunoglobulin-bound (immune-complex) form alone. Levels of HBV-DNA among HBV-DNA-positive donors were similar to those in the remission phase of acute hepatitis B.Digestion of sera with DNase 1 did not change the levels of HBV-DNA.Amino acid sequences of preS-S region were analyzed in six donors (three with subtype adr and three with subtype adw). Although each donor had different sequence, no common mutation was found. No mutation was found in the major hydrophobic region (MHR). These suggest that some HBsAg-negative, anti-HBc-positive blood donors have infectionsHBV in their sera. We analyzed the effect of such "occult" HBV on hepatocarcinogenesis among HCV-related and non-B, non-C hepatocellular carcinoma (HCC) cases. The effect among HCV-related HCC cases was low. The effect among non-B, non-C HCC cases should be carefully analyzed because genomic structure of such cases was different from that of blood donors.